Comparison of Different PEEP Titration Strategies Using Electrical Impedance Tomography in Patients With ARDS (DELTA)

University Hospital, Angers

Status: Completed

Conditions: Positive End Expiratory Pressure (PEEP); ARDS (Acute Respiratory Distress Syndrome); Electrical Impedance Tomography (EIT); Acute Lung Injury

Treatments: Other: Ventilation strategy

Study type: Interventional

Funder types: Other

Identifiers

NCT04247477

49RC19_0249

Details and patient eligibility

About

The aim of the this study is to assess the short term physiological effects of 3 ventilation strategies for adult patients with ARDS admitted to intensive care unit.

Two of those strategies are based on electrical impedance tomography (EIT) monitoring.

Enrollment: 22 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients with moderate to severe ARDS, defined by the Berlin consensus, at 12 to 48h from diagnosis
• PaO2/FiO2 ratio < 150 mmHg
• Patient affiliated to or beneficiary of a health care plan
• Consent obtained from patient's SDM

Exclusion criteria

• Pneumothorax
• Contraindication to the insertion of a nasogastric tube with an esophageal balloon
• Contraindication to the use of Electrical impedance tomography
• Pregnancy, lactating or parturient woman

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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22 participants in 2 patient groups

A-B-A-C

Experimental group

Description:

Four consecutive steps (45 min per step) are tested in the following order: Peep titration strategy according to Express method (A) - Peep titration strategy according to overdistension and collapse estimation (B) - Peep titration strategy according to Express method (A) - Peep titration strategy according to estimation of lung inhomogeneity (C)

Treatment:

Other: Ventilation strategy

A-C-A-B

Experimental group

Description:

Four consecutive steps (45 min per step) are tested in the following order: Peep titration strategy according to Express method (A) - Peep titration strategy according to estimation of lung inhomogeneity (C) - Peep titration strategy according to Express method (A) - Peep titration strategy according to overdistension and collapse estimation (B)

Treatment:

Other: Ventilation strategy