Electrical Impedance Tomography And Mechanical Ventilation Liberation In Tracheostomized Subjects : Physiological Assessment
Posted Date: Aug 12, 2024
- Investigator: Brian Ring
- Specialties:
- Type of Study: Observational/Survey
Electrical impedance tomography (EIT) has been increasingly used at the bedside in the last two decades to evaluate mechanical ventilation (MV), lung physiology, and perfusion distribution. Generally, a major focus of interest concerning using EIT as a monitor and clinical tool is to support personalized MV for patients within the nadir of their clinical progression. There has been increasing interest in understanding the physiological changes associated with the transition phase termed ventilator liberation and subsequent extubation. Ventilator liberation is defined as the weaning process leading to removal of the endotracheal tube (ETT) (i.e., extubation) and eventual ventilator discontinuation. During most ventilator liberation protocols, the patient transitions from breathing with minimal positive pressure inspiratory support to relying on normal physiological mechanics of a breath to producing negative alveolar pressure generated by the muscles of respiration. Although EIT-guided ventilator liberation has been investigated, there have been no studies analyzing the utility of EIT during the transition from MV to a tracheostomy collar trial (TCT); the tracheostomized patient population may present with unique physiological characteristics due to the rationale and sequelae associated with tracheostomy placement. Patients with tracheostomy tubes have generally been mechanically ventilated for a longer duration, have conditions that inhibit their ability to consistently protect their airway, or are otherwise deconditioned from extensive critical illness. Thus, findings from cohorts considered for MV liberation from and ETT are not entirely applicable to tracheostomized patients. This study will assess, and document physiological changes associated with TCT success or failure to drive trust and confidence in the monitoring tool in bedside providers and generate relevant variables associated with TCT outcomes in surgery/trauma subjects
Criteria:
Null
Keywords:
Mechanical Ventilation, Ventilator Liberation, Pulmonary Physiology
For More Information:
Brian Ring
919-491-7267
ringba@ucmail.uc.edu