Effectiveness of Ventilation Modes in Intensive Care: A Comparison of Mandatory Minute Ventilation and Synchronized Intermittant Mandatory Ventilation Using Bioelectrical Impedance Tomography

Recruiting now

Conditions studied: Ventilation Modes, Mechanical Ventilation, Critical Illness, Respiratory Support, Intensive Care Unit (ICU) Patients, Mechanical Ventilation Dependence, Evaluation of Mechanical Ventilation Modes (SIMV and MMV) in Adult Intensive Care Unit Patients Using Electrical Impedance Tomography

In brief

Synchronized Intermittent Mandatory Ventilation (SIMV) is a commonly used ventilatory mode available in many modern ventilators, frequently applied in intensive care units for patients requiring invasive mechanical ventilation. SIMV delivers a preset tidal volume or pressure at a predetermined respiratory rate and synchronizes with the patient's spontaneous breathing efforts, thereby enhancing patient-ventilator interaction and contributing to rehabilitation. Mandatory Minute Ventilation (MMV) is a hybrid mode combining features of SIMV and Pressure Support Ventilation (PSV), guaranteeing a preset minute ventilation (tidal volume × respiratory rate). It synchronizes support based on the patient's spontaneous efforts and compensates in cases of insufficient minute ventilation. Electrical Impedance Tomography (EIT) is a non-invasive, radiation-free imaging technique that enables real-time monitoring of pulmonary ventilation and perfusion by applying alternating electrical currents through surface electrodes. EIT has demonstrated strong correlation with findings from computed tomography, nitrogen washout, PET, and SPECT imaging modalities. This study aims to evaluate the effectiveness of MMV compared to SIMV in mechanically ventilated, hemodynamically stable adult patients (\>18 years old) in the intensive care unit. Patients must not require vasopressors, have a FiO₂ ≤ 60%, PEEP ≤ 8 cmH₂O, or receive neuromuscular blocking agents. Patients will be monitored under both SIMV and MMV modes, separated by a 12-hour interval. To minimize carry-over effects, a one-hour washout period will be implemented before data collection with EIT. Key parameters including PO₂/FiO₂ ratio, PaCO₂, and EtCO₂ will be assessed. The sequence of ventilatory mode application will follow a crossover study design.

Key facts

Study ID

NCT06961227

Run by

Harran University

People needed

25

Starts

2025-03-10

Expected to finish

2025-10-31

Last updated by the study team

2025-05-07

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Age ≥ 18 years
• Intubated and receiving invasive mechanical ventilation
• Hemodynamically stable (no vasopressor support)
• FiO₂ ≤ 60%
• PEEP ≤ 8 cmH₂O
• Not receiving neuromuscular blocking agents
• Able to tolerate switching between SIMV and MMV modes

You may not qualify if…

• Pregnant or breastfeeding patients
• Patients with neuromuscular diseases affecting respiratory drive
• Unstable hemodynamics or ongoing need for vasopressors
• Patients requiring high PEEP (>8 cmH₂O)
• Patients with DNR (do not resuscitate) status
• Participation in another interventional study

Where it is running

• Harran University Faculty of Medicine, Department of Anesthesiology and Reanimation — Sanliurfa, Turkey (Türkiye) (enrolling)

Full record on ClinicalTrials.gov

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