Effect of Post-suction Recruitment on Lung Volume in Mechanically Ventilated ICU Patients
Trial Parameters
Brief Summary
Patients who are intubated and mechanically ventilated in the intensive care unit (ICU) require repeated endotracheal suctioning to remove airway secretions. Although this procedure is necessary, it can cause a temporary collapse of lung units (alveolar derecruitment), leading to a decrease in lung volume and impaired oxygenation. A recruitment maneuver consists of briefly applying a higher airway pressure after suctioning in order to reopen collapsed lung areas and restore lung volume. However, the clinical benefit of performing a recruitment maneuver systematically after suctioning remains uncertain. This study aims to evaluate whether performing a recruitment maneuver immediately after closed-circuit endotracheal suctioning improves lung volume compared with suctioning alone. Lung volume will be assessed using electrical impedance tomography (EIT), a non-invasive bedside imaging technique that allows real-time monitoring of lung aeration. In a randomized crossover design, each patient will undergo two suctioning procedures: one followed by a recruitment maneuver and one without, in a random order. The main outcome will be the change in end-expiratory lung volume 15 minutes after suctioning. The results may help optimize ventilatory care in mechanically ventilated ICU patients.
Eligibility Criteria
Inclusion Criteria: * Adults aged ≥18 years * Covered by national health insurance * Admitted to the intensive care unit * Intubated and mechanically ventilated * Neuromuscular blockade at inclusion * Written informed consent obtained from a legally authorized representative or next of kin Exclusion Criteria: * Contraindication to electrical impedance tomography (e.g. pacemaker, implantable cardioverter-defibrillator, or implanted electrical stimulation device) * Contraindication to recruitment maneuvers (e.g. emphysema, undrained pneumothorax, hemodynamic instability) * Refractory intracranial hypertension * Acute respiratory distress syndrome requiring prone positioning * Pregnant or breastfeeding women * Patients deprived of liberty or under legal protection * Any condition judged by the investigator to interfere with study evaluation