Early PP Monitored by EIT in Patients With ARDS

Capital Medical University

Status: Enrolling

Conditions: Acute Respiratory Distress Syndrome

Treatments: Procedure: Lung protective ventilation group; Procedure: EIT-guided mechanical ventilation strategy

Study type: Interventional

Funder types: Other

Identifiers

NCT05822869

2022-KE-616

Details and patient eligibility

About

Acute Respiratory Distress Syndrome (ARDS) is a syndrome characterized by respiratory distress and refractory hypoxemia caused by pulmonary and extra-pulmonary factors. Despite improvements in diagnosis and treatment in recent years, the mortality rate of severe ARDS is still around 40%. The distribution of lung lesions in ARDS patients is significantly gravity-dependent. Even with lung-protective ventilation strategies, tidal volume is concentrated in the ventral lung region, leading to ventilator-associated lung injury. Prone position ventilation can increase ventilation to the dorsal lung tissue and improve the ventilation-perfusion ratio, thus improving oxygenation. During prone position ventilation in ARDS patients, lung-protective ventilation strategies should be maintained, but with different respiratory mechanics from the supine position, requiring adjustment of ventilator parameters. Electrical Impedance Tomography (EIT) technology can be used for bedside monitoring of mechanically ventilated patients, providing real-time feedback on the patient's ventilation status and having great potential for clinical applications. Investigators believes that EIT monitoring during prone position ventilation in ARDS patients can individualize lung-protective ventilation strategies, minimize alveolar overdistension and collapse, improve the weaning success rate of invasive ventilation, and ultimately improve patient prognosis.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age ≥ 18 years old；
2. Meets the diagnostic criteria for ARDS according to the 2012 Berlin definition；
3. Intubation with invasive mechanical ventilation time < 36 hours；
4. PaO2/FiO2 < 150mmHg.

Exclusion criteria

1. Contraindication to the prone position;
2. Contraindication to the EIT;
3. Patients have received extracorporeal membrane oxygenation treatment.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

EIT guided group

Experimental group

Description:

During prone ventilation, the PEEP level is adjusted based on EIT monitoring.

Treatment:

Procedure: EIT-guided mechanical ventilation strategy

Lung protective ventilation group

Other group

Description:

Lung-protective ventilation strategy during prone positioning that continues the supine position.

Treatment:

Procedure: Lung protective ventilation group