The Changes in End Expiratory Lung Impedence Measured by EIT and End Expiratory Lung Volume Measured by Passive Expiratory in Controlled Mechanical Ventilated Exacerbation COPD Patients

Study Overview
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Brief Summary
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The pathophysiological characteristics of respiratory failure on exacerbation of chronic pulmonary obstructive disease are the rapid deteriorate of respiratory symptoms, combined with aggravated flow limitation, gas trapping, dynamic pulmonary hyperinflation (DPH), therefore the intrinsic PEEP (PEEPi) increases. It is worthwhile to explore bedside methods to quantify the changes in dynamic pulmonary hyperinflation to guide safe and effective mechanical ventilation in airflow limited patients.

Detailed Description
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The study hypothesizes that the electrical impedence tomography (EIT) measured the changes of end expiratory lung impedence (△EELI） could accurately predict the changes of end expiratory lung volume （△EELV） measured by passive expiratory in controlled mechanical ventilated exacerbation COPD patients. The research intended to conduct a research to explore the relationship between △EELI and △EELV induced by external PEEP changes in ventilated exacerbation COPD patients.

Official Title
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The Relevance and Consistency Study of Changes in End Expiratory Lung Impedence Measured by EIT and End Expiratory Lung Volume Measured by Passive Expiratory in Controlled Mechanical Ventilated Exacerbation COPD Patients

Conditions
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COPD

Intervention / Treatment
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* Diagnostic Test: the changes of end expiratory lung impedence
* Diagnostic Test: the changes of end expiratory lung volume


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 2022.7-2023.1 exacerbation COPD invasive ventilated patients admitted to the first affiliated Guangzhou medical university; 35 to 80 years old; in stable condition judged by clinicians Exclusion Criteria: SpO2<88%; instable hemodynamic (MAP<65mmHg；Norepinephrine> 0.1ug/kg.min); pregnancy; 4 hour intravenous diuretics use before research; chest deformity and trauma, subpleural pulmonary bulla; implanted electronic devices(cardiac pacemaker, implantable cardioversion defibrillator,ect); tumour or other organ dysfunction; refuse to signature the informed consent

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PEEP titration for mechanical ventilated AECOPD patients<br>Pre- and post-self-controlled trials for invasive mechanical ventilated AECOPD patients during PEEP titration. | Diagnostic Test: the changes of end expiratory lung impedence<br>* the changes of end expiratory lung impedence measured by EIT<br>* Other names: △EELI;Diagnostic Test: the changes of end expiratory lung volume<br>* the changes of end expiratory lung volume measured by apnea method<br>* Other names: △EELV;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the changes of end expiratory lung volume | measured by EIT and IC maneuver | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intrinsic PEEP | measured by Esophageal balloon catheters | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COPD, dynamic pulmonary hyperinflation, mechanical ventilation, end expiratory lung impedence