Comparison of Pressure Support and Pressure Control Ventilation in Chronic Respiratory Failure
Summary
This study is looking at whether there is a difference in outcomes using two different types of breathing support in those patients who have chronic respiratory failure (patients who under-breathe).
There is little data to demonstrate which mode of ventilation is better in terms of physiological outcomes and outcome data relating to patient symptoms.
We hypothesize that one type of breathing support: pressure support ventilation would be more comfortable for patients as it more closely matches a patient's own respiratory pattern and and so leads to improved adherence and consequent improvement in quality of life.
Patients with respiratory failure will be randomly assigned to receive either pressure support ventilation or pressure control ventilation for the first 6 weeks and then cross-over to receive the mode not previously used for a further 6 weeks. They will have baseline data recorded and then be followed up after each 6 week block.
Study Design
Allocation: Randomized, Control: Active Control, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
Conditions
COPD
Intervention
Pressure support ventilation, Pressure control ventilation
Location
Guy's and St Thomas' NHS Foundation Trust
London
United Kingdom
SE1 7EH
Status
Recruiting
Source
Guy's and St Thomas' NHS Foundation Trust
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00994552
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Ventilator Weaning
Techniques for effecting the transition of the respiratory-failure patient from mechanical ventilation to spontaneous ventilation, while meeting the criteria that tidal volume be above a given threshold (greater than 5 ml/kg), respiratory frequency be below a given count (less than 30 breaths/min), and oxygen partial pressure be above a given threshold (PaO2 greater than 50mm Hg). Weaning studies focus on finding methods to monitor and predict the outcome of mechanical ventilator weaning as well as finding ventilatory support techniques which will facilitate successful weaning. Present methods include intermittent mandatory ventilation, intermittent positive pressure ventilation, and mandatory minute volume ventilation.
High-frequency Ventilation
Ventilatory support system using frequencies from 60-900 cycles/min or more. Three types of systems have been distinguished on the basis of rates, volumes, and the system used. They are high frequency positive-pressure ventilation (HFPPV); HIGH-FREQUENCY JET VENTILATION; (HFJV); and high-frequency oscillation (HFO).
Intermittent Positive-pressure Ventilation
Application of positive pressure to the inspiratory phase when the patient has an artificial airway in place and is connected to a ventilator.
Positive-pressure Respiration
A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange.
High-frequency Jet Ventilation
Respiratory support system used primarily with rates of about 100 to 200/min with volumes of from about one to three times predicted anatomic dead space. Used to treat respiratory failure and maintain ventilation under severe circumstances.
Clinical Trials
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Adaptive Support Ventilation in the Weaning of COPD
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PubMed Articles
Contrasting pressure-support ventilation and helium-oxygen during exercise in severe COPD.
Helium-oxygen mixtures and pressure-support ventilation have been used to unload the respiratory muscles and increase exercise tolerance in COPD. Considering the different characteristics of these tec...
ABSTRACT: We describe difficult weaning after prolonged mechanical ventilation in three tracheostomized children affected by respiratory virus infection. Although the spontaneous breathing trials were...
Respiratory mechanics in COPD patients who failed non-invasive ventilation: Role of intrinsic PEEP.
Non-invasive positive pressure ventilation (NPPV) is the first choice to treat exacerbations in COPD patients. NPPV can fail owing to different causes related to gas exchange impairment (RF group) or...
Non-invasive mechanical ventilation in COPD.
Non-invasive mechanical ventilation is the preferred method for the treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease (COPD). Primary contraindications and...
Chronic Respiratory Failure: The Role of Home Mechanical Ventilation.
While negative pressure ventilation using cuirass respirators or iron-lung machines was prevailing in the first part of the 20 (th) century, the polio epidemic in Copenhagen 1952 marks the turning poi...
