Study on Using the Throughflow System to Reduce Breathing Effort in Adults with Acute Respiratory Failure on Mechanical Ventilation

What this Trial Is About

Researchers are investigating the use of the Throughflow system in patients with acute hypoxemic respiratory failure who require invasive mechanical ventilation. The study focuses on reducing diaphragm and lung injury caused by mechanical ventilation, which can result from either disuse or excessive muscle loading. The Throughflow system aims to decrease anatomical dead space, thereby lowering ventilatory demands and respiratory drive, which may help protect the diaphragm and lungs during breathing support. The intervention involves using the Throughflow device that delivers a constant flow of fresh gas free of CO2 during inspiration. This device reduces the CO2 that remains in the upper airway after exhalation without increasing the tidal volume. During the ventilation titration phase, Throughflow settings will be adjusted in steps, starting from 0 LPM up to a maximum flow, with measurements taken every 10 minutes to determine optimal settings. Adjustments to the NAVA flow will be made accordingly to maintain total flow. Participants will be closely monitored through esophageal pressure swings, dynamic driving transpulmonary pressure, and oxygenation levels over 24 hours. Serious adverse events will also be tracked during this period. The study involves patients who are invasively ventilated with specific criteria for respiratory failure and lung imaging findings. The total involvement includes measurement collections during the Throughflow titration phase to assess respiratory effort and lung pressures under different settings.

Feasibility of Reducing Respiratory Drive Using the Through-flow System