Assessment of the Capability of PulmoVista 500 to Continuously Monitor Changes of Ventilation Over Time

Study Overview
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Brief Summary
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The results of this study will help to define the capability and reliability of PulmoVista 500 to detect changes in both global and regional ventilation.

Official Title
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Assessment of the Capability of PulmoVista 500 to Continuously Monitor Changes of Ventilation Over Time

Conditions
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Mechanical Ventilation, Single-lung Ventilation, ARDS, ALI - Acute Lung Injury, Weaning From Ventilator

Intervention / Treatment
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* Device: Lung Monitoring with EIT device (PulmoVista 500)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria - The population included in the clinical study will be selected from a pool of patients undergoing respiratory support who are scheduled to have their ventilation settings changed. As a subgroup, patients who are scheduled for surgeries that need one-lung-ventilation (OLV) will be enrolled to the study. Male and female patients at the age of 18 years or older On respiratory support in ICU care or scheduled for such ( e.g. postoperatively) or scheduled for surgery with OLV Patients of which the monitoring of ventilation distribution may be of clinical interest Patients being ventilated via an artificial airway with a mechanical ventilator that is compatible with PulmoVista 500 Patients scheduled for changes in ventilation settings that may cause relevant changes in the ventilation Chest circumference between 70 and 150 cm Written informed consent to participate in the study provided by either the patient or the legal representative of the patient. Exclusion Criteria Currently has a permanent or temporary pacemaker, implantable cardiac device (ICD) or other device emitting electrical energy a BMI ≥ 50 tidal volume (VT) ≤ 200 mL Current uncontrolled body movements such as tics, tremors or seizures, Current wound dressings or infections on the chest that might interfere with the PulmoVista 500 electrode belt placement Women of child bearing potential whose pregnancy cannot be excluded based on a pregnancy test or other proven facts. Allergic to materials used in the electrode belt Participation of the patient in an interventional trial within the last four weeks before enrollment in this trial Evidence suggesting that the patient or his legal representative is not likely to follow the trial protocol (e.g. lacking compliance) Known infectious diseases that require isolation of patient (e.g. MRSA) Concomitant use of an air anti-decubitus medical mattress with dynamic inflation that cannot be deactivated during EIT measurements

Ages Eligible for Study
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Minimum Age: 18 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ICU Patients<br>Patients currently on or scheduled for ventilator care in the intensive-care-unit (ICU) | Device: Lung Monitoring with EIT device (PulmoVista 500)<br>* Patient's lungs will be monitored during clinical routine interventions with Dräger's EIT device (PulmoVista 500). No medical interventions to routine patient care required.<br>|
| OLV Patients<br>Patients scheduled for elective surgery receiving one-lung-ventilation (OLV) | Device: Lung Monitoring with EIT device (PulmoVista 500)<br>* Patient's lungs will be monitored during clinical routine interventions with Dräger's EIT device (PulmoVista 500). No medical interventions to routine patient care required.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Monitoring Capabilities of PulmoVista 500 | The cross-correlation between the volume curve of the ventilator and the global impedance curve of PulmoVista 500 was expressed by the cross-correlation coefficient R. The cross-correlation coefficient is a measure to quantify the relationship between the volume curve and the EIT curve. The correlation coefficient R can assume values between [-1, 1] to describe the relationship between the two curves, as is usual for a correlation. To calculate the correlation coefficient, a phase shift between the two curves was taken into account, so the cross-correlation between them was calculated. The phase shift or delay occurs when the signal from the fan is transmitted to the PulmoVista500. The cross-correlation coefficient is determined by calculating the correlation coefficient for the curves within a narrow range of Lags(-15 to 15 ) for each pair of curves and using the maximum value as the value of correlation coefficient (therefore it is called cross-correlation coefficient) | Day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Detection of Changes in Regional Ventilation | To assess the capability of PulmoVista 500 to detect changes in regional ventilation by evaluating the cross correlation between impedance waveforms derived from PulmoVista 500 and volume curves derived from ventilator during one-lung-ventilation. | Day 1 | 
| Assess Changes of Tidal Volumes | Assess that changes of tidal volumes induced by ventilator settings can be monitored by the Trends view To assess if the changes of tidal volumes induced by ventilator settings can be monitored by the Trends view, the physician was asked to answer following question of a questionnaire: Open the view End-insp. trend after the PEEP setting has been changed significantly (2 mbar or more). Set C1 at the lower and C2 at the higher PEEP level. Does the image Change: C2 minus C1 and/or the corresponding regional Tidal Variations show the expected redistribution of ventilation from ventral to dorsal? Possible answers were: No, Yes and N/A | Day 1 | 
| Assess Changes of the End-expiratory Lung Volumes | Assess that changes of the end-expiratory lung volumes (induced by e.g. PEEP changes, recruitment and suctioning maneuvers) can be monitored by dEELI trend view To assess if the changes of the end-expiratory lung volumes (induced by e.g. PEEP changes, recruitment and suctioning maneuvers) can be monitored by dEELI trend view, the physician was asked to answer following two question of a questionnaire: Question 1: Open the view dEELI trend after the PEEP setting has been changed. Set C1 at the lower and C2 at the higher PEEP level. Does the image dEELI: C2 minus C1 show the expected increase of end-exp. lung volume in turquoise (light-blue)? Question 2: Open the view dEELI trend after lung suction has been conducted. Set C1 at a phase before and C2 during or immediately after the lung suction. Does the image dEELI: C2 minus C1 show the expected decrease of lung volume in orange color? Possible answers for the both above mentioned questions were No,Yes or N/A2 | Day 1 | 
| Safety - Documentation of Any Safety Events | Documentation of any safety events related to the use of PulmoVista 500 | Day 1 | 
| Assessing the Use Specific Clinical Helpfulness of PulmoVista 500 by Particular Questionnaire. The Questions Which Were Asked Within the Questionaire Are Listed in the Outcome Measure Description | How easy is it to... Q1: ... identify within the Tidal Image, whether the right and the left lung are evenly ventilated? Q2: ... quantify the regional ventilation distribution as expressed by the regional Parameters TV ROI 1 - TV ROI 4? Q3: ... set the cursors to respective positions which allow you to compare ventilation distribution before and after the intervention? Q4: ... detect increases and/or decreases of regional ventilation? Q5: ... relate the regional ventilation distribution to and the corresponding parameters from the ventilator, which are displayed in the trend table to each other? Q7: ... set the cursors to respective positions which allows you assessing lung volume changes induced by the intervention? Q8: ... detect increases and/or decreases of regional lung volume? How useful is the clinical Information on... Q6: ... ventilation redistribution caused by this intervention? Q9: ... regional lung volume changes caused by this intervention? | Day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ventilation Monitoring, Electrical Impedance Tomography