Actively Recruiting
Inspiratory Work of Breathing Before and After Extubation in Lung Transplant Patients Using Mechanical Ventilation
Led by University Health Network, Toronto · Updated on 2025-06-12
67
Participants Needed
1
Research Sites
26 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Critically ill patients who cannot maintain their airway or breathe on their own often need tracheal intubation and mechanical ventilation. This research aims to study how different spontaneous breathing trial (SBT) techniques affect lung function and the effort of breathing before and after extubation in lung transplant patients in the intensive care unit. The study also evaluates a new non-invasive method to detect expiratory muscle activity during mechanical ventilation and SBT. Participants will undergo spontaneous breathing trials using two techniques: continuous positive airway pressure (CPAP) set at 5 cmH2O and zero end-expiratory pressure (ZEEP). Electrical impedance tomography (EIT) will be used to study end expiratory lung volume (EELV), while esophageal catheters measure lung pressures and work of breathing. These assessments will be repeated after the patient is safely extubated. The study also tests non-invasive occlusion maneuvers compared to the standard gastric balloon method to estimate expiratory muscle pressure. During the study, researchers will monitor lung function, respiratory mechanics, muscle function, blood gases, and muscle pressures using various devices including NutriVent balloons, EIT, respiratory monitors, and ultrasound. The main outcomes measured are changes in EELV during different breathing conditions and the ability of occlusion maneuvers to detect expiratory muscle effort. The study lasts up to 30 minutes after extubation or after starting the spontaneous breathing trial, with safety and lung function closely observed throughout.
CONDITIONS
Brief Title
Inspiratory Work of Breathing Before and After Extubation
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Adult patients who are intubated and receiving mechanical ventilation
You will not qualify if you...
- Contraindication for esophageal catheter insertion such as upper gastrointestinal surgery within prior 6 weeks or actively bleeding esophageal varices
- Presence of bronchopleural fistula
- Contraindication for electrical impedance tomography including chest burns, skin lesions on the thorax, chest wall bandaging limiting electrode placement, or unstable spinal lesions or fractures
- Pregnancy
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Duration - Up to 30 minutes before extubation
Participants undergo measurements using tools such as esophageal and gastric balloons, electrical impedance tomography, pneumotachograph, respiratory monitors, and respiratory muscle ultrasound to assess lung function and breathing effort before extubation.
1 visit (in-person)
Duration - Up to 30 minutes after extubation
Participants are observed during spontaneous breathing trial and up to 30 minutes after extubation to assess lung volume changes and expiratory muscle effort.
Continuous monitoring during this period
Trial Site Locations
Total: 1 location
1
Toronto General Hospital, University Health Network
Toronto, Ontario, Canada, M5G2C4
Actively Recruiting
Research Team
G
Glauco Plens, MD
How is the study designed?
Study Type
OBSERVATIONAL
Masking
N/A
Allocation
N/A
Model
N/A
Primary Purpose
N/A
Number of Arms
0
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