End-Expiratory Diaphragmatic Residual Contraction Index for Identifying Intrinsic PEEP and Assisting PEEP Titration: A Prospective Physiological Study

Starting soon

Conditions studied: Speckle Tracking, Diaphragm

In brief

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.

Key facts

Study ID

NCT07697703

Run by

Sir Run Run Shaw Hospital

People needed

100

Starts

2026-08-21

Expected to finish

2027-09-03

Last updated by the study team

2026-07-13

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age ≥ 18 years. Patients receiving invasive mechanical ventilation in Pressure Support Ventilation (PSV) mode.
• Clinically assessed as having a risk of dynamic intrinsic PEEP (PEEPi,dyn) or experiencing difficult weaning from mechanical ventilation.
• Presence of an indwelling esophageal balloon catheter (for reference standard measurements).
• Provision of written informed consent from the patient or legally authorized representative.

You may not qualify if…

• Pregnancy or lactation. Known esophageal diseases (e.g., esophageal varices, strictures, recent esophageal surgery) or contraindications to esophageal catheter placement.
• Severe hemodynamic instability (e.g., requiring high-dose vasoactive support, uncontrolled arrhythmias).
• Severe hypoxemia (PaO2/FiO2 < 100 mmHg) or severe hypercapnia with hemodynamic compromise at baseline.
• Conditions precluding ultrasound assessment of the diaphragm (e.g., extensive chest wall trauma, large pleural effusion, severe subcutaneous emphysema).
• Active spontaneous breathing with severe patient-ventilator asynchrony that cannot be stabilized during the trial.
• Anticipated extubation or withdrawal of life-sustaining treatment within the next 24 hours.
• Participation in another interventional clinical trial within the last 30 days.

Full record on ClinicalTrials.gov

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