Feasibility of Reducing Respiratory Drive Using the Through-flow System

Mechanical ventilation can lead to diaphragm and lung injury. During mechanical ventilation, the diaphragm could be completely rested or it could be overworked, either of which may cause diaphragm injury. Mechanical stress and strain applied by mechanical ventilation or by the patient's own respiratory muscles can also cause injury to the lungs. Diaphragm and lung injury are associated with increased morbidity and mortality. Throughflow is a novel system that can reduce dead space without the need to increase the tidal ventilation, reducing the ventilatory demands and respiratory drive.

Inclusion Criteria:PaO2/FiO2 less than or equal to 300 at time of screeningOral endotracheal intubation and mechanical ventilationBilateral airspace opacities on chest radiograph or chest CT scanExclusion Criteria:Contraindication to esophageal catheterization (upper gastrointestinal tract surgery within preceding 6 weeks, bleeding esophageal/gastric varices)Intubation for traumatic brain injury or strokeIntracranial hypertension (suspected or diagnosed by medical team)Anticipated liberation from mechanical ventilation within 24 hours