[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100053562":3},{"organization":4,"armGroups":7,"interventions":14,"overallOfficials":10,"centralContacts":20,"locations":10,"responsibleParty":30,"collaborators":10,"id":34,"slug":35,"hasResults":36,"nctId":37,"briefTitle":38,"officialTitle":38,"acronym":10,"eligibilityCriteria":39,"healthyVolunteers":36,"sex":40,"minAge":41,"maxAge":10,"enrollmentInfo":42,"targetDuration":10,"studyType":45,"phases":10,"briefSummary":46,"conditions":47,"keywords":10,"overallStatus":50,"whyStopped":10,"lastUpdateSubmitDate":51,"lastUpdatePostDateStruct":52,"startDateStruct":55,"completionDateStruct":57,"leadSponsor":59,"locationsCount":10},{"fullName":5,"class":6},"Sir Run Run Shaw Hospital","OTHER",[8],{"label":9,"type":10,"description":11,"interventionNames":12},"Patients Undergoing PEEP Step Trial and EDRC Assessment",null,"All enrolled patients will receive a standardized, short-term PEEP step trial while in Pressure Support Ventilation (PSV) mode. The trial consists of sequentially applying PEEP levels of Baseline, -2, +2, +4, and +6 cmH2O relative to the set PEEP. At each step, respiratory mechanics and patient-ventilator synchrony will be monitored. The primary intervention of interest is the assessment of End-Expiratory Diaphragmatic Residual Contraction (EDRC) via ultrasound to identify the presence of intrinsic PEEP (PEEPi) and to determine the optimal level of extrinsic PEEP that minimizes diaphragmatic effort and asynchrony.",[13],"Device: Short-term PEEP Step Trial and EDRC Ultrasound Assessment",[15],{"type":16,"name":17,"description":18,"armGroupLabels":19,"otherNames":10},"DEVICE","Short-term PEEP Step Trial and EDRC Ultrasound Assessment","This intervention involves a standardized, short-term PEEP step trial combined with a novel physiological assessment. During the trial, external PEEP is systematically adjusted in 2 cmH2O increments (Baseline, -2, +2, +4, +6 cmH2O) while maintaining stable Pressure Support Ventilation (PSV) settings. Simultaneously, the End-Expiratory Diaphragmatic Residual Contraction (EDRC) index is evaluated using diaphragm ultrasound speckle tracking. This distinguishes the intervention by providing a non-invasive, real-time quantification of residual diaphragmatic tension at end-expiration, which serves as a surrogate marker for dynamic intrinsic PEEP (PEEPi) and trigger load, distinguishing it from traditional static measurements or esophageal manometry alone.",[9],[21,26],{"name":22,"role":23,"phone":24,"phoneExt":10,"email":25},"Huiqing Ge, MD","CONTACT","+8613588706787","gehq@zju.edu.cn",{"name":27,"role":23,"phone":28,"phoneExt":10,"email":29},"YIqing Xu, Master","+86 13634115344","xuyiqing@srrsh.com",{"type":31,"investigatorFullName":32,"investigatorTitle":33,"investigatorAffiliation":5,"oldNameTitle":10,"oldOrganization":10},"PRINCIPAL_INVESTIGATOR","Huiqing Ge","Director of Respiratory Medicine","100053562","end-expiratory-diaphragmatic-residual-contraction-index-for-identifying-intrinsic-peep-and-assisting-peep-titration-a-prospective-physiological-study-100053562",false,"NCT07697703","End-Expiratory Diaphragmatic Residual Contraction Index for Identifying Intrinsic PEEP and Assisting PEEP Titration: A Prospective Physiological Study","Inclusion Criteria:\n\n* Age ≥ 18 years. Patients receiving invasive mechanical ventilation in Pressure Support Ventilation (PSV) mode.\n\nClinically assessed as having a risk of dynamic intrinsic PEEP (PEEPi,dyn) or experiencing difficult weaning from mechanical ventilation.\n\nPresence of an indwelling esophageal balloon catheter (for reference standard measurements).\n\nProvision of written informed consent from the patient or legally authorized representative.\n\nExclusion Criteria:\n\n* Pregnancy or lactation. Known esophageal diseases (e.g., esophageal varices, strictures, recent esophageal surgery) or contraindications to esophageal catheter placement.\n\nSevere hemodynamic instability (e.g., requiring high-dose vasoactive support, uncontrolled arrhythmias).\n\nSevere hypoxemia (PaO2\u002FFiO2 \\\u003C 100 mmHg) or severe hypercapnia with hemodynamic compromise at baseline.\n\nConditions precluding ultrasound assessment of the diaphragm (e.g., extensive chest wall trauma, large pleural effusion, severe subcutaneous emphysema).\n\nActive spontaneous breathing with severe patient-ventilator asynchrony that cannot be stabilized during the trial.\n\nAnticipated extubation or withdrawal of life-sustaining treatment within the next 24 hours.\n\nParticipation in another interventional clinical trial within the last 30 days.","ALL","18 Years",{"count":43,"type":44},100,"ESTIMATED","OBSERVATIONAL","This study proposes the End-expiratory Diaphragmatic Residual Contraction (EDRC) index to quantify residual diaphragmatic activity at end-expiration during Pressure Support Ventilation (PSV) mode. The study aims to validate the relationship between EDRC and dynamic intrinsic PEEP (PEEPi), triggering load, patient-ventilator asynchrony, and PEEP responsiveness through a brief, standardized PEEP titration trial conducted within a clinically safe range. This will provide a basis for subsequent individualized PEEP setting guided by EDRC.",[48,49],"Speckle Tracking","Diaphragm","NOT_YET_RECRUITING","2026-07-05",{"date":53,"type":54},"2026-07-13","ACTUAL",{"date":56,"type":44},"2026-08-21",{"date":58,"type":44},"2027-09-03",{"name":5,"class":6}]