Clinical Research Directory

Influence of Personalized Lung Volume Optimization Maneuver on Lung Function and Cardiac Performance in Children

The goal of this randomized interventional clinical trial is to learn if a standardized lung volume optimization maneuver (LVOM) is beneficial in 1. study) children undergoing biventricular repair of their congenital heart disease (CHD) with cardiopulmonary bypass and 2. study) in children with severe respiratory failure at risk for or need for ECMO. The main questions it aims to answer are: Main hypotheses of CHD study: Does a standardized PEEP-Titration maneuver, to optimize end-expiratory lung volume improve: * cardiac performance * lung function Does it make a difference in: * length of ventilation * ventilation/perfusion mismatch of the lung * need for vasopressor support? Main hypotheses of ECMO study: Does a LVOM in children/infants with severe respiratory failure /ARDS * improve lung compliance and gas exchange * facilitate lung protective ventilation according to PALICC-2 guidelines * improve lung aeration and V/Q-matching assessed with EIT Does it make a difference in * need for ECMO * duration of ECMO runs * hemodynamics stability

Influence of Lung Volume Optimization Maneuver in Ventilated Children on Cardiac Output and Lung Compliance in Children With Congenital Heart Disease Undergoing Surgical Repair

The goal of this randomized interventional clinical trial is to learn if a standardized lung volume optimization maneuver (LVOM) is beneficial in children undergoing biventricular repair of their congenital heart disease (CHD) with cardiopulmonary bypass. Main hypotheses: Does a standardized PEEP-Titration maneuver, to optimize end-expiratory lung volume improve: * cardiac performance * lung function Does it make a difference in: * length of ventilation * ventilation/perfusion mismatch of the lung * need for vasopressor support?

Combined Acupressure Effects on Post-Thoracotomy Pain and Lung Volume

Pain is a subjective, sensory and emotionally unpleasant experience resulting from real or hidden injuries in tissues. The pain experience is a subjective and unique experience in physiological and psychological terms and is the first negative sensory experience of the patient after the surgical procedure. Thoracotomy is an invasive surgical incision that causes severe postoperative pain due to the negative effect on the ribs, muscles and peripheral nerves. During thoracic surgery, anatomical lung resection is performed through posterolateral thoracotomy. Surgical incision during thoracotomy surgery is the most severe cause of postoperative pain. Epidural analgesia, peripheral nerve block and systematic treatment methods are used in post-thoracotomy pain management. Opioid use is frequently preferred in post-thoracotomy pain management. Although thoracotomy pain can mostly be controlled with opioid analgesics, excessive use of opioids may lead to respiratory suppression, constipation, suppression of cough, nausea, vomiting and many other possible side effects. Ineffective postoperative pain management may lead to postoperative complications such as increased cardiac workload, prolonged pulmonary rehabilitation and delayed wound healing. The use of holistic non-drug pain relief methods is vital in reducing the need for opioid analgesics and the risk of possible side effects in early postoperative pain management.

Pulmonary Volume Changes During Synchonized Noninvasive Positive Pressure Ventilation

Current evidence suggests that noninvasive positive pressure ventilation (NIPPV) is more effective than continuous positive airway pressure (CPAP) in preventing respiratory failure in preterm infants with respiratory distress syndrome (RDS), both as initial and post-extubation support. NIPPV may be delivered in synchronized (sNIPPV) or non-synchronized (nsNIPPV) modes, with sNIPPV offering clear benefits by coordinating support with the infant's own breathing. Recent studies indicate sNIPPV is superior to nsNIPPV in preventing respiratory failure, though the intrapulmonary mechanisms behind this advantage remain unclear. To address this, the present study uses Electrical Impedance Tomography (EIT) to evaluate how lung volume changes during different types of breaths and ventilator inflations - spontaneous breaths, synchronized inflations, non-synchronized inflations, and backup inflations - in preterm infants receiving sNIPPV.