Comparison of guiding sedation level by respiratory effort versus usual care in mechanically ventilated patients: A randomized controlled trial protocol

Abstract

Background: Critically ill patients relying on mechanical ventilation often require excessive sedation, aiming to address asynchrony and prevent ventilator-induced lung injury (VILI). Unintentionally, there may be more suppression of respiratory efforts. It is well-established that improper respiratory efforts during mechanical ventilation can cause unfavorable outcomes. Methods: Researchers conducted a single-center randomized control trial, parallel 2 groups (1:1 ratio), with 164 participants. One intervention group employed the optimal respiratory effort (predicted ΔPL, P0.1), and the other control group, employed usual care to guide the adjustment of sedative levels. Hypothesis: To compare 28-day ventilator-free day (VFD) and mortality between measuring respiratory effort as opposed to usual care and adjusting sedative level during mechanical ventilation. Conclusions: This study will evaluate the disparity in 28-day VFD and mortality between sedative level guidance by respiratory effort and usual care. Keywords: Respiratory effort; Acute respiratory distress syndrome; Dynamic transpulmonary driving pressure swing; Sedation protocol