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Use of 'Mechanical Power' as a Predictor of Increased Serum and Pulmonary Proinflammatory Cytokine Concentrations in Patients With Acute Hypoxemic Respiratory Failure: A Prospective Observational Study

Use of 'Mechanical Power' as a Predictor of Increased Serum and Pulmonary Proinflammatory Cytokine Concentrations in Patients With Acute Hypoxemic Respiratory Failure: A Prospective Observational Study

Recruiting
18 years and older
All
Phase N/A

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Overview

The aim of this study is to report the proportion of patients with acute hypoxemic respiratory failyre (AHRF) undergoing mechanical ventilation who exceed 17 J/min of mechanical power (MP) and the difference in terms of proinflammatory cytokine concentration in blood samples and bronchoalveolar lavage.

The main questions it aims to answer are:

  1. Which is the proportion of patients who exceed 17 J/min of mechanical power (MP) during the first 72 hours of mechanical ventilation?
  2. Is there a difference in terms of cytokine concentration in patients undergoing mechanical power >17 J/min compared to <17 J/min?

Patients will be divided into two groups based on respiratory mechanics measurements: low MP group (average MP <17 J/min) and high MP group (average MP ≥17 J/min). The researchers will collect blood and BAL samples and perform cytokine assays.

Eligibility

Inclusion Criteria:

  • Patients with AHRF (P/F <300 mmHg) undergoing invasive mechanical ventilation within 7 days from the onset of symptoms
  • Invasive mechanical ventilation for less than 6 hours
  • Evidence of newly developed lung consolidation on chest imaging (X-ray, CT)
  • Age ≥18 years

Exclusion Criteria:

  • Prior invasive mechanical ventilation during the same hospitalization
  • Tracheostomy
  • Severe anemia (Hb<7g/dL)
  • Severe neutropenia
  • Renal insufficiency or RRT (Renal Replacement Therapy)
  • Noradrenaline >0.5 mcg/kg/min
  • Pregnancy
  • Extracorporeal circulation (ECCO2R, ECMO)
  • Life expectancy <24 hours as clinically judged
  • Lack of consent

Study details
    Mechanical Power

NCT06425354

University of Roma La Sapienza

25 May 2024

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