Decremental Esophageal Catheter Filling Volume Titration For Transpulmonary Pressure Measurement

NCT ID: NCT06051292

Last Updated: 2025-03-20

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

RECRUITING

Clinical Phase

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-18

Study Completion Date

2025-12-30

Brief Summary

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Mechanical ventilation is a critical intervention in the management of pediatric patients with respiratory distress. During this process, accurate measurement of transpulmonary pressure (PL) is essential to ensure the safety and efficacy of ventilation. PL is defined as the difference between alveolar pressure (Palv) and pleural pressure (Ppl). While the direct measurement of Ppl is possible, it poses a risk to tissue integrity. Thus, the primary surrogate for Ppl measurement today is esophageal pressure (Pes).

However, the measurement of Pes is not without challenges. This abstract outlines the pitfalls associated with Pes measurement, emphasizing the importance of employing well-defined procedures to mitigate potential errors. These errors can range from underestimation of Pes due to underfilled catheters to overestimation resulting from overfilled catheters.

To address these challenges and optimize Pes measurement, various methods have been proposed for titrating the filling volume of the esophageal catheter. In this study, investigators aim to assess a faster decremental filling method and compare it to the traditionally accepted Mojoli method in the context of pediatric patients. This research seeks to enhance the intensivists' understanding of the most efficient and accurate approach to Pes measurement during mechanical ventilation in the pediatric population, ultimately contributing to improved patient care and outcomes

Detailed Description

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Conditions

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Pediatric Acute Respiratory Distress Syndrome (PARDS) Acute Respiratory Failure Acute Respiratory Distress Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Fast decremental

fast decremental catheter volume titration will be applied

Group Type EXPERIMENTAL

Fast method

Intervention Type OTHER

Fast decremental catheter volume titration will be applied and optimal filling volume will be determined according to the measurements

Conventional

conventional catheter volume titration will be applied

Group Type ACTIVE_COMPARATOR

Conventional method

Intervention Type OTHER

Conventional catheter volume titration will be applied and optimal filling volume will be determined according to the measurements

Interventions

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Fast method

Fast decremental catheter volume titration will be applied and optimal filling volume will be determined according to the measurements

Intervention Type OTHER

Conventional method

Conventional catheter volume titration will be applied and optimal filling volume will be determined according to the measurements

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Pediatric patients between 1 months and 18 years
* Patients need mechanical ventilation support without modification of ventilation settings within the upcoming 2 hours
* Informed consent was signed by next of kin
* Requiring esophageal catheter application

Exclusion Criteria

* Patients eligible for extubation or modification of ventilation settings within the upcoming 2 hours
* Patient included in another interventional study in the last 30 days
* Patients unable to undergo esophageal catheter insertion due to congenital or acquired pathologies
* Patient included in another interventional research study under consent
* Patient already enrolled in the present study in a previous episode of acute respiratory failure
Minimum Eligible Age

1 Month

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dr. Behcet Uz Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Hasan ağın

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hasan Agin, Professor

Role: STUDY_DIRECTOR

Behcet Uz Children's Hospital

Locations

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Aydin Obstetric and pediatrics Hospital

Aydin, , Turkey (Türkiye)

Site Status RECRUITING

Erzurum Regional Research and Training Hospital

Erzurum, , Turkey (Türkiye)

Site Status RECRUITING

Cam Sakura Research and Training Hospital

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

The Health Sciences University Izmir Behçet Uz Child Health and Diseases Research and Training Hospital

Izmir, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Hasan Agin, Professor

Role: CONTACT

05362013162

Gokhan Ceylan, Associate Professor

Role: CONTACT

0794542397

Facility Contacts

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ekin soydan

Role: primary

+905321003949

Pinar Hepduman, MD

Role: primary

+905531501115

Mustafa Colak, MD

Role: primary

+905554180903

Ozlem Sandal, MD

Role: primary

+905067644688

References

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Mojoli F, Chiumello D, Pozzi M, Algieri I, Bianzina S, Luoni S, Volta CA, Braschi A, Brochard L. Esophageal pressure measurements under different conditions of intrathoracic pressure. An in vitro study of second generation balloon catheters. Minerva Anestesiol. 2015 Aug;81(8):855-64. Epub 2015 Jan 30.

Reference Type BACKGROUND
PMID: 25634481 (View on PubMed)

Hotz JC, Sodetani CT, Van Steenbergen J, Khemani RG, Deakers TW, Newth CJ. Measurements Obtained From Esophageal Balloon Catheters Are Affected by the Esophageal Balloon Filling Volume in Children With ARDS. Respir Care. 2018 Feb;63(2):177-186. doi: 10.4187/respcare.05685. Epub 2017 Oct 31.

Reference Type BACKGROUND
PMID: 29089460 (View on PubMed)

Mojoli F, Iotti GA, Torriglia F, Pozzi M, Volta CA, Bianzina S, Braschi A, Brochard L. In vivo calibration of esophageal pressure in the mechanically ventilated patient makes measurements reliable. Crit Care. 2016 Apr 11;20:98. doi: 10.1186/s13054-016-1278-5.

Reference Type BACKGROUND
PMID: 27063290 (View on PubMed)

Other Identifiers

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02020395

Identifier Type: -

Identifier Source: org_study_id

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