End-expiratory Trans-pulmonary Pressure Guided PEEP Titration in Patients With Pulmonary Fibrosis and UIP Pattern Undergoing Mechanical Ventilation

Sponsor
University of Modena and Reggio Emilia
Study ID
NCT05098717
Status
Recruiting
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Conditions

  • Idiopathic Pulmonary Fibrosis
  • Mechanical Ventilation Pressure High

Eligibility Criteria

Sex
ALL
Age
18 Years - 90 Years
Healthy Volunteers
Not accepted

Study Details

Patients with pulmonary fibrosis and associated usual interstitial pneumonia that require mechanical ventilation for acute respiratory failure experience poor clinical outcomes. This may be influenced by the unfavorable interaction between the fibrotic lung and the stress and strain stimuli generated during controlled ventilation. Although there is no consensus on how to ventilate these patients, much of the recommendations followed in clinical practice are taken from the experience on patients with acute respiratory distress syndrome. Among these, measuring the esophageal pressures and adjusting positive-end expiatory pressure to make trans-pulmonary pressures positive can decrease atelectasis, derecruitment of lung, and cyclical opening and closing of airways and alveoli, thus optimizing lung mechanics and oxygenation. The effect of this strategy on the fibrotic lung has not yet been documented. With this observational study we aim at documenting the effect of PEEP titration maneuver based on end-expiratory trans-pulmonary pressure on lung mechanics of patients with pulmonary fibrosis and UIP pattern,

Key Dates

First listed
Oct 28, 2021
Start date
Feb 8, 2023
Status verified
Apr 2025
Primary completion
Jan 1, 2026
Completion
Jan 1, 2027

Study Design

Enrollment
40 participants (estimated)

Arms

  • Arm: UIP patients
    Patients with pulmonary fibrosis and UIP pattern undergoing mechanical ventilation for acute respiratory failure
  • Arm: ARDS patients
    Patients with ARDS undergoing mechanical ventilation for acute respiratory failure

Primary Outcome Measure

Lung elastance [ Time Frame: 2 hours. ]

Central Contacts

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