Effect of Post-suction Recruitment on Lung Volume in Mechanically Ventilated ICU Patients

NCT07358039 | Recruiting

• 2 other identifiers: 2025-CHITS-0132025-A01845-44
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

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.

Conditions

Mechanical Ventilation

Keywords

Endotracheal suction; Alveolar recruitment; Electrical impedance tomography; End-expiratory lung volume; Intensive care; Mechanical ventilation

Outcome Measures

Primary Outcomes (1)

• Percentage change in end-expiratory lung volume (EELV) after suctioning

  EELV assessed by end-expiratory lung impedance measured with electrical impedance tomography (PulmoVista® V500).

  15 minutes after endotracheal suctioning

Secondary Outcomes (3)

• Change in lung compliance

  Baseline and 15 minutes after suctioning

• Change in functional residual capacity (FRC)

  Baseline and 15 minutes after suctioning

• Change in PaO₂/FiO₂ ratio

  Baseline and 15 minutes after suctioning

Study Arms (2)

A

EXPERIMENTAL

Patients undergo closed-circuit endotracheal suctioning without a recruitment maneuver.

Procedure: Closed-circuit endotracheal suctioning

B

EXPERIMENTAL

Patients undergo closed-circuit endotracheal suctioning immediately followed by a recruitment maneuver.

Procedure: Suction + Recruitment maneuver

Interventions

Suction + Recruitment maneuver PROCEDURE

After suctioning, a recruitment maneuver is applied consisting of an airway pressure of 30 cmH₂O maintained for 30 seconds, without changing the positive end-expiratory pressure.

B

Closed-circuit endotracheal suctioning PROCEDURE

Standard closed-circuit endotracheal suctioning performed for less than 15 seconds without disconnecting the ventilator.

A

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged ≥18 years
• Covered by national health insurance
• Admitted to the intensive care unit
• Intubated and mechanically ventilated
• Written informed consent obtained from a legally authorized representative or next of kin

You may not qualify if:

• 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

Sponsors & Collaborators

• Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer: lead

Study Sites (1)

Hôpital National d'Instruction des Armées Sainte-Anne

Toulon, VAR, 83000, France

RECRUITING

Related Publications (4)

• Morrow B, Futter M, Argent A. A recruitment manoeuvre performed after endotracheal suction does not increase dynamic compliance in ventilated paediatric patients: a randomised controlled trial. Aust J Physiother. 2007;53(3):163-9. doi: 10.1016/s0004-9514(07)70023-5.

  PMID: 17725473 BACKGROUND

• Kasim I, Gulyas M, Almgren B, Hogman M. A recruitment breath manoeuvre directly after endotracheal suction improves lung function: an experimental study in pigs. Ups J Med Sci. 2009;114(3):129-35. doi: 10.1080/03009730903177357.

  PMID: 19736601 BACKGROUND

• Jesus AC, Figueiredo AM, Cordeiro ALL. Recruitment maneuvers in patients with acute respiratory distress syndrome: a systematic review and metanalysis. Einstein (Sao Paulo). 2024 Dec 16;22:eRW0372. doi: 10.31744/einstein_journal/2024RW0372. eCollection 2024.

  PMID: 39699411 BACKGROUND

• Blakeman TC, Scott JB, Yoder MA, Capellari E, Strickland SL. AARC Clinical Practice Guidelines: Artificial Airway Suctioning. Respir Care. 2022 Feb;67(2):258-271. doi: 10.4187/respcare.09548.

  PMID: 35078900 BACKGROUND

MeSH Terms

Interventions

Suction

Intervention Hierarchy (Ancestors)

Drainage; Surgical Procedures, Operative

Study Officials

• Cyril PERNOD, MD

  Hôpital National d'Instruction des Armées (HNIA) Sainte-Anne, Toulon

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Asmaa JOBIC, Ph.D

CONTACT

04 83 77 20 61; asmaa.jobic@ch-toulon.fr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 14, 2026
• First Posted: January 22, 2026
• Study Start: April 2, 2026
• Primary Completion (Estimated): April 1, 2027
• Study Completion (Estimated): April 1, 2027
• Last Updated: April 13, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)