ETROPON: End-expiratory Trans-pulmonary Pressure Guided PEEP Titration in Patients With Pulmonary Fibrosis and UIP Pattern Undergoing Mechanical Ventilation
Study Details
Study Description
Brief Summary
Patients with pulmonary fibrosis and associated usual interstitial pneumonia that require mechanical ventilation for acute respiratory failure experience poor clinical outcomes. This may be influenced by the unfavorable interaction between the fibrotic lung and the stress and strain stimuli generated during controlled ventilation. Although there is no consensus on how to ventilate these patients, much of the recommendations followed in clinical practice are taken from the experience on patients with acute respiratory distress syndrome. Among these, measuring the esophageal pressures and adjusting positive-end expiatory pressure to make trans-pulmonary pressures positive can decrease atelectasis, derecruitment of lung, and cyclical opening and closing of airways and alveoli, thus optimizing lung mechanics and oxygenation. The effect of this strategy on the fibrotic lung has not yet been documented. With this observational study we aim at documenting the effect of PEEP titration maneuver based on end-expiratory trans-pulmonary pressure on lung mechanics of patients with pulmonary fibrosis and UIP pattern,
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
UIP patients Patients with pulmonary fibrosis and UIP pattern undergoing mechanical ventilation for acute respiratory failure |
|
ARDS patients Patients with ARDS undergoing mechanical ventilation for acute respiratory failure |
Outcome Measures
Primary Outcome Measures
- Lung elastance [2 hours.]
The effect of PEEP titration according to end-expiratory transpulmonary pressure on lung elastance will be analyzed.
Secondary Outcome Measures
- P/F ratio [2 hours]
The effect of PEEP titration according to end-expiratory transpulmonary pressure on P/F ratio will be analyzed.
Eligibility Criteria
Criteria
Inclusion Criteria:
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pulmonary fibrosis with UIP pattern
-
subjected to endotracheal intubation and controlled mechanical ventilation for acute respiratory failure
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candidate to a trial of PEEP titration according to positive end expiratory pressure.
Exclusion Criteria:
-
chest wall deformities
-
chronic obstructive pulmonary disease
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Azienda Ospedaliero Universitaria Policlinico di Modena | Modena | Italy |
Sponsors and Collaborators
- University of Modena and Reggio Emilia
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- UModenaReggio11