Electrical Impedance Tomography for Optimization of Positive End-Expiratory Pressure: Acute Respiratory Distress Syndrome

University of Michigan

Status: Completed

Conditions: Acute Respiratory Distress Syndrome; ARDS

Treatments: Device: PEEP titration by EIT; Other: Usual care

Study type: Interventional

Funder types: Other

Identifiers

NCT03793842

HUM00148126

Details and patient eligibility

About

Doctors follow a standard ventilator management strategy when making adjustments to the breathing machine to optimize the amount of oxygen into the lungs. The purpose of this study is to assess whether the EIT (electrical impedance tomography) device can be an additional useful tool for ventilator management and identifying the ideal positive end-expiratory pressure (PEEP).

Enrollment: 16 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Endotracheal ventilation for < 1 week (168 hours)
• Presence of all of the following conditions for < 48 hours i. Partial pressure of oxygen to percentage of inspired oxygen (PaO2/FiO2) < 150 with PEEP > 5 cm water for > 30 min.

ii. bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules iii. respiratory failure not fully explained by cardiac failure or fluid overload

-All criteria listed in (3) developed within 1 week of a known clinical insult or new or worsening respiratory symptoms

Exclusion criteria

• Lack of informed consent
• Known pregnancy
• Extracorporeal membrane oxygenation (ECMO) use
• Severe chronic respiratory disease requiring home oxygen therapy or ventilation
• Calculated BMI of greater than 50

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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16 participants in 2 patient groups

Usual care then PEEP titration by Electrical Impedance Tomography (EIT)

Experimental group

Description:

Patients in the usual care first group will continue to receive mechanical ventilation according to the University of Michigan Acute Respiratory Distress Syndrome (ARDS) protocol high-PEEP arm

Treatment:

Other: Usual care

Device: PEEP titration by EIT

PEEP titration by EIT then usual care

Experimental group

Description:

Patients in the high PEEP titration by EIT first will have receive ventilation with a PEEP determined by EIT titration procedure.

Treatment:

Other: Usual care

Device: PEEP titration by EIT