Respiratory Function Monitoring of Mechanical Ventilation in Patients With Chest Blunt Injury

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

NOT_YET_RECRUITING

Total Enrollment

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-05-31

Study Completion Date

2026-07-31

Brief Summary

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The goal of this observational study is to learn about EIT in observing the application of lung protective ventilation strategies in patients with pulmonary contusion, particularly the impact on pulmonary ventilation blood flow ratio, oxygen, and condition. The main question it aims to answer is:

Can lung protective ventilation strategies improve respiratory function in patients with severe chest contusion? We will collect clinical data of participants who already taking lung protective ventilation strategies as part of their regular medical care.

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Detailed Description

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Trauma is the leading cause of death among middle-aged and young people in China, with over 25% of patients dying from chest trauma. The incidence of pulmonary contusion in severe chest trauma is over 70%, and it is an important cause of respiratory failure and even death in patients. The occurrence of pulmonary contusion and respiratory failure in patients with chest contusion is a dynamic process, and Regional inhomogeneities of the damaged lung should be taken into consideration to develop improved ventilation strategies. Currently, there is no ideal monitoring method to evaluate the severity of injury, and guide the ventilation strategies. Electrical impedance tomography (EIT) is a non-invasive, radiation-free imaging technique. It measures regional lung ventilation and aeration distribution by means of changes in electrical potentials at the skin surface of the chest wall during breathing cycles, which has been proven to have good practicality in patients with non-invasive ARDS and pulmonary embolism. In this study, we aim to characterize the physiologic effects of positive end expiratory pressure (PEEP) on key mechanisms of regional lung protection, namely: recruitment, reduced atelectrauma, and improved ventilation-perfusion matching, by CT scan and EIT

Conditions

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Lung Contusion

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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EIT-PEEP group

The PEEP titration guided by EIT, decided by the responsible attending physician

PEEP setting strategy

Intervention Type OTHER

The attending physician selects different PEEP setting strategies

Table-PEEP group

The PEEP setting with low FiO2-PEEP table, decided by the responsible attending physician

PEEP setting strategy

Intervention Type OTHER

The attending physician selects different PEEP setting strategies

Interventions

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PEEP setting strategy

The attending physician selects different PEEP setting strategies

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients with severe chest contusion admitted to the intensive care unit (ICU);
* Abbreviated Injury Scale (AIS) ≥ 3 and/or Blunt Pulmonary Contusion 18 score (BPC18) ≥ 3;
* Age range from 18 to 90 years old;
* Mechanical ventilation;
* Stay in the ICU for less than 12 hours.

Exclusion Criteria

* Perinatal women;
* Expected to be mechanically ventilated for less than 48 h;
* Expected duration of stay in the ICU is less than 24 hours;
* There are contraindications for the use of EIT (pacemaker implantation, local skin wounds after chest surgery, etc.);
* Accept extracorporeal membrane oxygenator;
* Mechanical ventilation\>7 days;
* Confirmed ventilator-associated pneumonia;
* Pneumothorax without drainage or presence of subcutaneous emphysema.

Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No