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A Pilot Trial of Pressure Muscle Index-Targeted PSV Trial

RecruitingNAAges 18 Years - anyAllCapital Medical University
NCT06769360 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Pressure support ventilation (PSV) is one of the most frequently used ventilator modes in the intensive care unit (ICU). The successful implementation of PSV depends on matching the patient's inspiratory effort with the ventilator support. In clinical practice, the pressure support level is usually set and adjusted according to tidal volume (VT) and respiratory rate (RR). However, these parameters may not fully represent the patient's effort. Previous studies have shown that pressure muscle index (PMI), which is measured as the difference between the peak and plateau airway pressure during an end-inspiratory airway occlusion, could reliably determine the low and high inspiratory effort during PSV. However, the comparative effectiveness of these two pressure support level setting strategies remains uncertain. Our aim is to explore clinical and implementation factors relevant to a future

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📋 Eligibility rules (as published)
Inclusion Criteria: 1. PSV initiated during the last 24 hours, whether transition from controlled modes or primary initiation; 2. Mechanical ventilation expected to be required for at least 24-48 hours by responsible physicians; 3. The partial pressure of oxygen in arterial blood (PaO2)/inspired oxygen fraction (FiO2) ≤ 300 mmHg (measuring at clinical FiO2 and positive end-expiratory pressure \[PEEP\]); 4. No sedation or stable sedation with Richmond Agitation Sedation Scale (RASS) of -2 to +1 or Riker's Sedation-Agitation Scale (SAS) of 3 to 4. Exclusion Criteria: 1. Age younger than 18 years old; 2. Initiation of PSV before ICU admission; 3. Duration of mechanical ventilation longer than 7 days before enrollment; 4. History of neuromuscular diseases; 5. Clinical suspicion of increased intracranial pressure; 6. Presentation with pneumothorax and/or bronchopleural fistula; 7. Extracorporeal support; 8. Moribund conditions; 9. Refusal by the ICU physicians or the patient.
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What it tests

  • PMI-targeted PSV setting
  • VT/RR-targeted PSV setting
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Where

1 site
Beijing Tiantan Hospital
Beijing, China
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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