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PEEP-induced Effects on Respiratory dRivE and EFfort

RecruitingNAAges 18 Years - anyAllRadboud University Medical Center
NCT07203781 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Rationale: In patients with acute hypoxemic respiratory failure (AHRF), preserving spontaneous breathing during mechanical ventilation offers physiological benefits, but also carries risks. While spontaneous breathing improves gas exchange and limits diaphragm atrophy, strong inspiratory efforts may worsen lung and diaphragm injury. Balancing these factors requires refined and tailored strategies, such as the modulation of PEEP. However, the impact of PEEP on neural respiratory drive and inspiratory effort is very heterogenous, and these two entities have only been studied separately in limited subsets of patients and healthy subjects. Additionally, it remains unclear whether the major determinant of PEEP-induced changes in respiratory drive and effort is represented by variations in diaphragm geometry, lung compliance, or by the presence of expiratory muscles recruitment, which may cou

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📋 Eligibility rules (as published)
Inclusion Criteria: * Age \> 18 years * Acute hypoxemic respiratory failure (AHRF) with a PaO2/FiO2-ratio ≤ 200 * Patient on invasive assisted mechanical ventilation in pressure support mode exhibiting valid inspiratory efforts (occlusion pressure \> 5 cmH2O). Exclusion Criteria: * Pre-existent neuromuscular disease * History of chronic respiratory failure requiring long-term oxygen therapy * Muscle paralysis * Pneumothorax * Contra-indication to EIT monitoring (e.g. burns, pacemaker, thoracic wounds limiting electrode placement) * Contra-indications for EAdi or oesophageal balloon catheter placement (e.g. history of gastric bypass surgery, gastro-oesophageal junction surgery, oesophageal stricture, recent upper gastrointestinal hemorrhage or known/suspected varices).
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What it tests

  • PEEP level changes
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Where

1 site
Radboudumc
Nijmegen, Netherlands
🤝 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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