Mechanical Ventilation Guided By Transpulmonary and Airway Driving Pressures

Overview

About this study

The purpose of this study is to test the correspondence between Airway Driving Pressure (DPAW; defined as plateau pressure minus positive end-expiratory pressure) and transpulmonary driving pressure (DPTP)—the quotient of tidal volume and lung compliance (CL), in response to intra-abdominal hypertension and changes in positive end-expiratory pressure during laparoscopic and robotic surgical interventions requiring intra-abdominal insufflation.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Patients requiring mechanical ventilation for abdominal laparoscopic and robotic surgeries.
  • Patients who are passively ventilated (no respiratory efforts) as a result of the sedation plan determined entirely by the primary anesthesia team --research team will not influence or participate on the sedation protocol plan or implementation.
  • Patients who are clinically stable and able to tolerate the changes in position that are routinely conducted as part of the standard of care in the operative room.
  • Patient/responsible family member signing the informed consent must speak English.

Exclusion Criteria:

  • Patients with open abdomen prior to surgical procedures.
  • Body mass index (BMI) greater than 35.
  • Patients with clinically evident spontaneous breathing efforts (ventilator wave forms) during surgical procedure.
  • Patients with clinical suspicion of elevated intra-cranial pressure (requiring head elevation).
  • Contraindication to body position change, as dictated by surgery-specific protocol.
  • Unstable cardio-respiratory insufficiency.
  • Age less than 18 years.
  • Cuff leak in endotracheal / tracheostomy tube.
  • Patient/responsible family member unable to understand the informed consent in English.
  • Patient with contraindication for nasogastric tube placement:
    • Severe midface trauma
    • Recent nasal surgery
    • Coagulation abnormality
    • Esophageal varices or stricture
    • Recent banding of esophageal varices
    • Alkaline ingestion

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Richard Oeckler, M.D., Ph.D.

Closed for enrollment

Contact information:

Linda Weise R.R.T., L.R.T.

(507) 293-2535

Weise.Linda@mayo.edu

More information

Publications

Publications are currently not available

Study Results Summary

Not yet available

Supplemental Study Information

Not yet available

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CLS-20359111

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