Decremental Esophageal Catheter Filling Volume Titration For Esophageal Pressure Measurement in Pediatric Respiratory Distress

What this Trial Is About

Researchers are studying pediatric patients with acute respiratory distress syndrome and acute respiratory failure who require mechanical ventilation. The study focuses on measuring transpulmonary pressure (PL), which is important for safe and effective ventilation. Since direct measurement of pleural pressure (Ppl) risks tissue damage, esophageal pressure (Pes) is used as a safer surrogate. However, measuring Pes accurately can be challenging due to potential errors from incorrect catheter filling volumes. The trial compares two methods of adjusting the esophageal catheter's filling volume to optimize Pes measurement in children: a faster decremental method and the conventional Mojoli method. Participants will be randomly assigned to receive either the fast decremental volume titration or the conventional titration technique. Both approaches aim to find the optimal catheter volume within one hour after placement. During the study, children on mechanical ventilation will receive esophageal catheter insertion, and clinicians will monitor and measure Pes and transpulmonary driving pressure over the hour after catheter placement. The primary outcome is determining the best catheter filling volume; secondary outcomes include the transpulmonary driving pressure and the time taken for measurement. The study is double-blind and randomized, ensuring careful assessment of each method's accuracy and efficiency.

Decremental Esophageal Catheter Filling Volume Titration For Transpulmonary Pressure Measurement