Patient-ventilator Asynchrony During Mechanical Invasive Assisted-ventilation in Pediatric Patients (NavPed-Inv)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified August 2010 by University Hospital, Geneva.
Recruitment status was  Recruiting
Sponsor:
Information provided by:
University Hospital, Geneva
ClinicalTrials.gov Identifier:
NCT01193023
First received: August 31, 2010
Last updated: NA
Last verified: August 2010
History: No changes posted

August 31, 2010
August 31, 2010
June 2010
June 2011   (final data collection date for primary outcome measure)
asynchronies [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Asynchronies during mechanical ventilation are the following: Auto triggering, double triggering, late cycling, premature cycling and ineffective effort.

all ventilatory parameters are recorded under Pressure support (3 phases: 3 levels of expiratory trigger setting, initial, +10% and -10%, 15 min, 5 min and 5 min respectively) and NAVA (1 phase, 20 min).

Asynchronies will be determined by measuring each ventilatory cycle of all recordings.

Same as current
No Changes Posted
Not Provided
Not Provided
Not Provided
Not Provided
 
Patient-ventilator Asynchrony During Mechanical Invasive Assisted-ventilation in Pediatric Patients
Patient-ventilator Asynchrony During Mechanical Invasive Assisted-ventilation in Pediatric Patients

The purpose of this study is to document the prevalence and type of asynchronies incidence during invasive mechanical ventilation in pediatric patients breathing under pressure support.

And to observe the impact of adjusting the expiratory trigger setting on asynchronies, and compare these incidences with asynchronies measured in pediatric patient breathing under NAVA system (Neurally Adjusted Ventilatory Assist).

Two sessions will be recorded, one in PSV, one with NAVA, delivered in a random order after being sure the infant is calm and comfortable, according to his parents and/or the nurse in charge.

Criteria for initiating invasive ventilation and to start PSV will follow the usual practice guidelines of the unit.

Ventilation parameters in PS will be adjusted by the clinician in charge of the patient, as usual based on clinical observation. Investigators will not interfere with ventilator settings. Ventilation will be applied via an endotracheal tube, uncuffed for the majority (if infant < 5 years), according to commonly applied guidelines in this unit.

One 15 minutes session will be recorded, after being sure the infant is calm and comfortable according to the parents and/or the nurse in charge. Then the clinician in charge of the patient will modify the ETS, first decreasing it of 10% below the initial set value, and will be recorded the following 5 minutes after stabilization and secondly increasing it of 10% above the initial set value, and will be recorded the following 5 minutes after stabilization.

NAVA will be set to deliver initially the same peak pressure (comparable level of assist) than during the initial PS period. Same PEEP will be delivered in both modes. This is possible with a pre-visualization window, allowing adjustments before switching to the NAVA mode. Nava ventilation will be recorded during 20 minutes.

The 2 sessions, Pressure support and Nava, will be recorded consecutively.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Basic Science
Respiration, Artificial
  • Other: Pressure Support
    Ventilation under pressure support
  • Device: NAVA
    Ventilation under NAVA
  • Active Comparator: Pressure support

    in this arm, pressure support will be recorded under 3 conditions:

    • with the initial Expiratory Trigger Setting (ETS)
    • with ETS +10%
    • with ETS -10%
    Intervention: Other: Pressure Support
  • Experimental: NAVA
    Neurally Adjusted ventilatory Assist is a ventilation mode where the ventilator is piloted by the electrical activity of the diaphragm Ventilation is triggered and cycled off by the electrical activity of the diaphragm, the pressure delivered being proportional to this activity.
    Intervention: Device: NAVA
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
40
June 2011
June 2011   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • all consecutive patients from 4 weeks to 12 years (post natal interm infants) admitted to the pediatric intensive care unit (PICU) and receiving mechanical ventilation in pressure support ventilation

Exclusion Criteria:

  • Non treated pneumothorax
  • Hemodynamic instability
  • At least 2 hours following the admission in the PICU in post cardiac surgery
  • FiO2 > 0.6
  • Poor short term prognosis (defined as a high risk of death in the next seven days)
  • contraindication for gastric tube or obtention of a reliable EMGdi signal
  • Known esophageal problem (hiatal hernia, esophageal varicosities)
  • Active upper gastro-intestinal bleeding or any other contraindication to the insertion of a naso-gastric tube
  • Neuromuscular disease
  • Patients with a pacemaker
Both
up to 12 Years
No
Contact: Laurence Vignaux 0041223727448 laurence.vignaux@hcuge.ch
Contact: Peter Rimensberger Tél: + 41-22 37 24 730 peter.rimensberger@hcuge.ch
Switzerland
 
NCT01193023
HUG-matped 09-253
Yes
Dr Peter Rimensberger, neonatology and intensive care units, university hospital of Geneva
University Hospital, Geneva
Not Provided
Principal Investigator: Peter Rimensberger, MD Ûniversity hospital of Geneva
University Hospital, Geneva
August 2010

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP