About this trial
Mechanical ventilation can lead to diaphragm and lung injury. During mechanical ventilation, the diaphragm could be completely rested or it could be overworked, either of which may cause diaphragm injury. Mechanical stress and strain applied by mechanical ventilation or by the patient's own respiratory muscles can also cause injury to the lungs. Diaphragm and lung injury are associated with increased morbidity and mortality. Throughflow is a novel system that can reduce dead space without the need to increase the tidal ventilation, reducing the ventilatory demands and respiratory drive.
Eligibility criteria
Qualifiers
PaO2/FiO2 less than or equal to 300 at time of screening
Oral endotracheal intubation with ETT 7.5 or 8.0 and on invasive mechanical ventilation
Bilateral airspace opacities on chest radiograph or chest CT scan
Disqualifiers
Contraindication to esophageal catheterization (upper gastrointestinal tract surgery within preceding 6 weeks, bleeding esophageal/gastric varices)
Intubation for traumatic brain injury or stroke
Intracranial hypertension (suspected or diagnosed by medical team)
Anticipated liberation from mechanical ventilation within 24 hours
Trial design
Treatments tested in this trial
- Throughflow titration phase
Treatment groups
Sponsors and collaborators
University Health Network, Toronto
Lead sponsor
Unity Health Toronto
Collaborator