NCT03314701

Mechanical Ventilation in Multiple Fracture Ribs

Biphasic Intermittent Positive Airway Pressure (BIPAP) Versus Airway Pressure Release Ventilation (APRV) in Patients With Multiple Fracture Ribs

• Status: Unknown
• Phase: N/A
• Study type: Interventional
• Enrollment: 60 (estimated)
• Sponsor: Assiut University · Academic / Other
• Sex: All
• Age: 18 Years – 80 Years
• Healthy volunteers: Not accepted

Summary

Chest trauma is the most common injury in the emergency trauma and rib fractures is the most common trauma in chest trauma. Severe rib fractures can cause paradoxical respiration and mediastinal swing, which has large effects on respiratory and circulatory system, result in acute respiratory distress syndrome. Mechanical ventilation can significantly improve the hypoxemia of the patients, correct paradoxical respiration, and treat the pulmonary atelectasis

Detailed description

To compare between Biphasic Intermittent Positive Airway Pressure (BIPAP) ventilation and Airway Pressure Release Ventilation (APRV) mode in patients with multiple fracture ribs as regard: * Resting Energy Expenditure * Oxygenation * Stability of Physiological Status as cardiovascular activity * cardiac output * arterial blood gas measurement including \[ blood PH, arterial oxygen tension, arterial carbon dioxide tension, bicarbonate level and base deficit\] * lung and chest compliance * Length of intensive care unit stay. * The ICU mortality rate. * The development of major complications as nosocomial infection (hospital acquired pneumonia and ventilator associated pneumonia), major atelectasis and pneumothorax.

Conditions

• Mechanical Ventilation

Interventions

Type	Name	Description
DEVICE	Biphasic Intermittent Positive Airway Pressure (BIPAP)	Following endotracheal intubation BIPAP mode will be started with: * Inspiratory positive airway pressure \[IPAP\] at 20 cmH2O * Expiratory positive airway pressure \[EPAP\] at 5 cmH2O * PRESSURE SUPPORT is difference between these two pressures \[IPAP\]- \[EPAP\] * Mandatory pressure will be delivered at rate of 10-12/min. To produce an end tidal carbon dioxide partial pressure in the range of 35-40 mmHg hypercapnia will not be allowed
DEVICE	Airway Pressure Release Ventilation (APRV)	* high airway pressure (Phigh) will be set at 20 cmH2O * low airway pressure ( Plow) will be set at 5 cmH2O * the release phase setting will be adjusted to terminate the peak expiratory flow rate to ≥ 50%; release frequency of 10-12 cycles/min * T high at 4.5-6 seconds * T low at 0.5 to 0.8 second

Timeline

• Start date: 2017-10-25
• Primary completion: 2018-10-01
• Completion: 2018-12-01
• First posted: 2017-10-19
• Last updated: 2018-07-09

Locations

1 site across 1 country: Egypt