Effect of Electric Impedance Tomography-Guided PEEP Titration

Southeast University, China

Status: Completed

Conditions: ARDS, Human

Treatments: Device: PEEP selection

Study type: Interventional

Funder types: Other

Identifiers

NCT05736185

EIT-PEEPstudy

Details and patient eligibility

About

Acute respiratory syndrome distress (ARDS) is a clinical common syndrome with high mortality. Mechanical ventilation (MV) is the cornerstone of management of ARDS but can lead to ventilator-induced lung injury. Positive end-expiratory pressure (PEEP), as one of main component of MV, has been widely used in the clinical practice. However, how to best set PEEP is still a difficult problem for moderate to severe ARDS patients. EIT, an imaging tool evaluating the regional ventilation distribution at the bedside, can achieve the individual PEEP selection for all mechanically ventilated patients. This article compared the effect of PEEP titrated guided by EIT with fraction of inspired oxygen (FiO2)-PEEP table on the ventilation-perfusion mismatch.

Enrollment: 69 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Intubated patients with moderate and severe ARDS (Berlin definition, PaO2/FiO2 ≤200 mmHg at PEEP 5 cmH2O)
2. undergoing deep sedation on controlled mechanical ventilation within72 hours after ARDS onset

Exclusion criteria

1. age <18 years old
2. patient undergoing legal protection
3. contra-indications to EIT (e. g. severe chest trauma or wounds)
4. pneumothorax
5. patient undergoing ECMO
6. pregnancy

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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69 participants in 3 patient groups

EIT-PEEP strategy

Experimental group

Description:

PEEP selected by EIT which remained at 15 min

Treatment:

Device: PEEP selection

Low FiO2-PEEP strategy

Experimental group

Description:

PEEP selected by low FiO2-PEEP table which remained at 15 min

Treatment:

Device: PEEP selection

High FiO2-PEEP strategy

Experimental group

Description:

PEEP selected by high FiO2-PEEP table which remained at 15 min

Treatment:

Device: PEEP selection