Effect of Three Modalities of Spontaneous Breathing Tests on Respiratory Efforts in Tracheostomized Patients

NCT ID: NCT03856424

Last Updated: 2022-06-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

18 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-08

Study Completion Date

2023-12-30

Brief Summary

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Datas are lacking concerning weaning from mechanical ventilation for tracheostomized patients. In particular, the effect of different modalities of spontaneous breathing trials on respiratory effort has not been extensively described.

This crossover physiology study will include 18 tracheostomized patients ventilated for more than 72 hours.

The objective of this study is to compare the effect of three different modalities of SBTs on respiratory effort in tracheostomized patients. The modalities tested are : Pressure Support Ventilation (PSV level 5 cmH2O, PEEP 5 cmH2O), T-piece test and high-flow Oxygen. Each modality is applied in a randomized order, during 30 minutes. During every modality tested, esophageal and gastric pressure, expired CO2, and comfort will be monitored, in addition to standard monitoring. Based on esophageal pressure monitoring, patient's respiratory efforts can be calculated either by esophageal pressure-time product and work of breathing. Pressure generated by inspiratory muscles will also be assessed.

Detailed Description

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Conditions

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Mechanical Ventilation Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Three different spontaneous breathing trials modalities will be tested in each patient in a randomized order. Washout periods will be performed between the tested modalities.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Modality 1 - Washout - Modality 2 - Washout - Modality 3

Three different 30-minute modalities of deventilation will be performed in a randomized order in each patient. Washout periods of 30 minutes will occur between tested modalities.

Group Type OTHER

Modality 1

Intervention Type PROCEDURE

Pressure support ventilation (PSV) modality

Modality 2

Intervention Type PROCEDURE

T-Piece modality

Modality 3

Intervention Type PROCEDURE

High-flow oxygen

Modality 1 - Washout - Modality 3 - Washout - Modality 2

Three different 30-minute modalities of deventilation will be performed in a randomized order in each patient. Washout periods of 30 minutes will occur between tested modalities.

Group Type OTHER

Modality 1

Intervention Type PROCEDURE

Pressure support ventilation (PSV) modality

Modality 2

Intervention Type PROCEDURE

T-Piece modality

Modality 3

Intervention Type PROCEDURE

High-flow oxygen

Modality 2 - Washout - Modality 1 - Washout - Modality 3

Three different 30-minute modalities of deventilation will be performed in a randomized order in each patient. Washout periods of 30 minutes will occur between tested modalities.

Group Type OTHER

Modality 1

Intervention Type PROCEDURE

Pressure support ventilation (PSV) modality

Modality 2

Intervention Type PROCEDURE

T-Piece modality

Modality 3

Intervention Type PROCEDURE

High-flow oxygen

Modality 2 - Washout - Modality 3 - Washout - Modality 1

Three different 30-minute modalities of deventilation will be performed in a randomized order in each patient. Washout periods of 30 minutes will occur between tested modalities.

Group Type OTHER

Modality 1

Intervention Type PROCEDURE

Pressure support ventilation (PSV) modality

Modality 2

Intervention Type PROCEDURE

T-Piece modality

Modality 3

Intervention Type PROCEDURE

High-flow oxygen

Modality 3 - Washout - Modality 2 - Washout - Modality 1

Three different 30-minute modalities of deventilation will be performed in a randomized order in each patient. Washout periods of 30 minutes will occur between tested modalities.

Group Type OTHER

Modality 1

Intervention Type PROCEDURE

Pressure support ventilation (PSV) modality

Modality 2

Intervention Type PROCEDURE

T-Piece modality

Modality 3

Intervention Type PROCEDURE

High-flow oxygen

Modality 3 - Washout - Modality 1 - Washout - Modality 2

Three different 30-minute modalities of deventilation will be performed in a randomized order in each patient. Washout periods of 30 minutes will occur between tested modalities.

Group Type OTHER

Modality 1

Intervention Type PROCEDURE

Pressure support ventilation (PSV) modality

Modality 2

Intervention Type PROCEDURE

T-Piece modality

Modality 3

Intervention Type PROCEDURE

High-flow oxygen

Interventions

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Modality 1

Pressure support ventilation (PSV) modality

Intervention Type PROCEDURE

Modality 2

T-Piece modality

Intervention Type PROCEDURE

Modality 3

High-flow oxygen

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients for whom a tracheostomy is planned
* Patients on invasive ventilation for \>72 hours

Exclusion Criteria

* Tracheostomy for upper airway obstruction or other disease
* Patients tracheostomized before current hospitalization
* Patients with Glasgow Coma Scale (GCS) \< 8/10 after cardiac arrest
* Patients with GCS \< 8/10 because of primary central neurologic disease
* Patients for whom therapeutic limitations have already been decided
* Patients for whom weaning from ventilation is not an objective
* Patients suffering from myasthenia gravis
* Patients with cardiac assistance device
* Patients with medullary lesion proximal to C5
* Patients for whom nasogastric tube insertion is contraindicated
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Piquilloud Imboden Lise

OTHER

Sponsor Role lead

Responsible Party

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Piquilloud Imboden Lise

Sponsor-investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Lise Piquilloud Imboden, MER&PD

Role: PRINCIPAL_INVESTIGATOR

University of Lausanne Hospitals

Locations

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Lausanne University Hospitals

Lausanne, Canton of Vaud, Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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Lise Piquilloud Imboden, MER&PD

Role: CONTACT

+41 79 556 68 27

Davy Cabrio

Role: CONTACT

+41 79 556 69 56

Facility Contacts

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Lise Piquilloud Imboden, PD&MER

Role: primary

+41 79 556 68 27

Other Identifiers

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TWEEP

Identifier Type: -

Identifier Source: org_study_id

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