Study of Breathing Effort and Lung Function Before and After Extubation in Adults on Mechanical Ventilation

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.

Inspiratory Work of Breathing Before and After Extubation