Using transpulmonary pressure to help obese patients wean off mechanical ventilation
Transpulmonary Pressure Guided Weaning From Invasive Mechanical Ventilation in Obese Patients With Respiratory Failure
This study tests if using a special pressure measurement can help obese patients come off mechanical ventilation faster and with fewer problems.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 128 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Mississippi Medical Center Academic / other |
| Locations | 1 site (Jackson, Mississippi) |
| Trial ID | NCT05530434 on ClinicalTrials.gov |
What this trial studies
This study investigates whether measuring transpulmonary pressure can improve the weaning process from mechanical ventilation in obese patients suffering from respiratory failure. By adjusting positive end expiratory pressure (PEEP) based on transpulmonary pressure, the research aims to reduce the duration of mechanical ventilation and associated complications. Patients will be divided into two groups: one receiving transpulmonary pressure-guided PEEP adjustments and the other receiving standard PEEP management. Daily assessments will be conducted to determine each patient's readiness for spontaneous breathing trials.
Who should consider this trial
Good fit: Ideal candidates are obese patients classified as class II or higher with a BMI of 35.0 kg/m2 or more, who are on invasive mechanical ventilation for respiratory failure for less than 48 hours.
Not a fit: Patients with contraindications to esophageal balloon catheter placement, known pleural disease, or those requiring chronic mechanical ventilation prior to enrollment may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could significantly reduce the time obese patients spend on mechanical ventilation, lowering their risk of complications.
How similar studies have performed: While the approach of using transpulmonary pressure is relatively novel, similar studies have shown promise in improving ventilation strategies in critically ill patients.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * on invasive mechanical ventilation for respiratory failure for \< 48 hours * obese class II or higher (BMI greater than or equal to 35.0 kg/m2) Exclusion Criteria: * contraindications to esophageal balloon catheter placement including esophageal, nasofacial, gastrointestinal abnormalities and platelets \<10,000/microliter * known pleural disease such as persistent pneumothorax, pleural effusion, or pleurodesis * neuromuscular disease * requires chronic mechanical ventilation prior to enrollment * severe neurologic injury * known difficult airway * life expectance is less than 48 hours
Where this trial is running
Jackson, Mississippi
- University of Mississippi Medical Center — Jackson, Mississippi, United States (Recruiting)
Study contacts
- Study coordinator: Meredith E Sloan, MD
- Email: mesloan@umc.edu
- Phone: 601-815-9634
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.