What this Trial Is About

Researchers are evaluating a new method to set pressure support ventilation (PSV) using the inspiratory muscle pressure index (PMI) in patients on mechanical ventilation. PSV is commonly used to help patients breathe by providing inspiratory support, but current guidelines for adjusting the pressure support level rely on tidal volume and respiratory rate, which can sometimes lead to too much or too little assistance. This study aims to test whether using PMI to guide pressure support settings can better match patient needs, protect the lungs and diaphragm, and improve ventilation outcomes. The study involves adjusting pressure support settings in patients receiving PSV to keep the PMI within a target range of 0 to 2 cmH2O. PMI is measured noninvasively at the bedside by calculating the difference between plateau pressure and airway peak pressure during a brief airway occlusion. This approach allows dynamic and personalized adjustment of ventilator support. The trial is a prospective multicenter randomized clinical study comparing this PMI-guided strategy against standard care. Participants will be monitored for inspiratory effort over the first 48 hours to assess how often their effort remains within a normal range. Researchers will collect data on lung and diaphragm protection and overall mechanical ventilation outcomes. The study will also evaluate whether using PMI-guided pressure support is practical and feasible in clinical settings. The total participation duration includes at least 48 hours of ventilator support evaluation and monitoring.

PMI Guide PS Setting in Pressure Support-ventilated Patients