How changing PEEP affects breathing drive and effort during pressure‑support ventilation

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is an interventional physiologic protocol that changes positive end‑expiratory pressure (PEEP) in invasively ventilated adults with acute hypoxemic respiratory failure (PaO2/FiO2 ≤ 200) who are breathing with pressure support and have measurable inspiratory efforts. While patients remain on assisted ventilation, investigators will record neural and mechanical measures of breathing (for example EAdi, oesophageal pressure, and electrical impedance tomography) as PEEP is adjusted to observe short‑term effects. The protocol aims to define how PEEP alters neural respiratory drive and inspiratory effort and to explore whether these effects are driven by diaphragm geometry, lung compliance, or recruitment of expiratory muscles. Procedures are performed at a single center with advanced physiologic monitoring during brief PEEP interventions.

Why it matters

Who can join: the full rules

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).

Where it's running

• Radboudumc
  Nijmegen, Gelderland, Netherlands Recruiting

Study contacts

• Principal investigator: Jonne Doorduin, PhD — Radboud University Medical Center
• Study coordinator: Tommaso Rosà, M.D.
• Email: tommaso.rosa@radboudumc.nl
• Phone: 06-50155757

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.