salbutamol 2.5 mg via vibrating mesh nebulizer (VMN)
salbutamol 2.5 mg via vibrating mesh nebulizer (VMN): To evaluate the patient's respiratory effort, the pressure-time product (PTPes) and the delta of Pes oscillations during inspiration (∆ Pes) will be obtained from the analysis of the Pes curve. Global and regional pulmonary tidal volumes will be evaluated with Electrical Impedance Tomography
Study summary
This is a prospective physiological interventional study that assess the feasibility and safety of administering salbutamol using a vibrating mesh nebulizer during HFNC in patients with acute hypoxemic respiratory failure (AHRF). We evaluate whether this method of salbutamol delivery can reduce inspiratory effort and improve global and regional lung ventilation in AHRF patients. To achieve this, the study will record and analyze the following: esophageal pressure (Pes) curves, global and regional tidal volumes, minute ventilation, and changes in global and regional lung ventilation assessed through Electrical Impedance Tomography (EIT).
Eligibility
Sex
ALL
Min age
18 Years
Max age
90 Years
Healthy volunteers
No
Inclusion Criteria:
* • Age \> 18, \< 90 years
* Non-intubated critically ill patients with AHRF due to pneumonia (diagnosis is based on the presence of infiltrates on chest X-ray and the onset of clinical signs of infection less than 7 days earlier)
* PaO2/FiO2 ≤ 300 mmHg
* Patients receiving oxygen therapy
Exclusion Criteria:
* • Age \< 18 years
* Hypercapnia (PaCO2 \> 50 mmHg)
* Hemodynamic instability (Systolic blood pressure \< 90 mmHg or Mean arterial pressure \< 60 or high dose of vasoactive drugs)
* Tachycardia or tachyarrhythmia (HR \> 130 b/min)
* Known allergy or intolerance to salbutamol
* Patient has received inhaled therapy with short-acting beta 2 agonists \< 8 hours before or with long-acting beta 2 agonists \< 24 hours before
* Acute exacerbation of COPD or bronchial asthma
* Cardiogenic pulmonary edema
* GCS ≤ 12
* Contraindication for EIT (e.g. ICD)
* Pregnancy
* Patient refuses to participate
Primary outcome measure(s)
To evaluate the changes of inspiratory effort based on the analysis of the oesophageal pressure curve. — The measurement of ΔPes will be conducted: After 20 minutes of ventilatory support with HFNC (Time 0) 10 minutes following the completion of Salbutamol administration (Time 1) At 1 hour, 2 hours, and 3 hours post-Salbutamol administration Our hypothesis is based on changes of inspiratory effort, based on the analysis of the delta esophageal pressure (ΔPes), after the administration of Salbutamol by via a vibrating mesh nebulizer during HFNC in patients with AHRF. Evaluating the delta esophageal pressure (ΔPes) requires careful measurement of esophageal pressure (Pes) during the respiratory cycle. ΔPes specifically reflects the inspiratory effort or the work of breathing (WOB), as it measures the difference between the maximum inspiratory and expiratory Pes values during each breath.
Trial sites (1)
Facility
City
Region
Status
Azienda ospedaliera Universitaria di Ferrara
Ferrara
Italy
More Università degli Studi di Ferrara trials in Italy
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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