Studying How High Positive End Expiratory Pressure Affects Breathing Effort in Adults Recovering from Acute Respiratory Distress Syndrome

What this Trial Is About

Researchers are studying patients recovering from Acute Respiratory Distress Syndrome ARDS who require invasive mechanical ventilation. The study evaluates how spontaneous breathing during the switch from controlled to assisted ventilation may worsen lung injury due to strong inspiratory effort and high respiratory drive. It focuses on the effects of higher Positive End Expiratory Pressure PEEP to reduce lung stress and inspiratory effort, while exploring simple ways to predict patient responses to PEEP by monitoring respiratory rate and lung compliance. Patients will be ventilated using pressure support ventilation with inspiratory pressure adjusted to achieve specific lung volume targets and a starting PEEP of 5 cmH2O. After initial measurements, PEEP will be increased to 10 and 15 cmH2O while keeping inspiratory pressure constant. During these steps, advanced respiratory monitoring including esophageal and transpulmonary pressure swings will be collected to assess lung compliance response and respiratory rate changes. Participants will be monitored continuously during the ventilation adjustments, with detailed respiratory assessments taken after 5 minutes at each PEEP level. Researchers will measure lung compliance as the primary outcome within 10 minutes, along with esophageal pressure, transpulmonary pressure swings, and respiratory rate as secondary outcomes. The study involves patients ventilated in pressure support mode expected to remain on ventilation for more than 24 hours after enrollment, with ongoing safety and lung function monitoring throughout participation.

Prediction of Inspiratory Effort Response to High PEEP in Patients Recovering From ARDS