Evaluation of POC Lung Ultrasound Combined With Pressure-volume Curve to Titration Adjust PEEP for ARDS Lung Recruitment

Shanghai Pudong New Area Gongli Hospital

Status: Unknown

Conditions: Acute Respiratory Distress Syndrome

Treatments: Diagnostic Test: Maximum Oxygenation; Device: Lung Ultrasound

Study type: Interventional

Funder types: Other

Identifiers

NCT03076450

201640405

Details and patient eligibility

About

Using lung ultrasound re-aeration score(LUS-RAS) combined with pressure-volume curve(PVC) adjust maintain positive end-expiratory pressure(PEEP) after recruitment maneuver, to achieve real-time adjustment, reduce ventilation-associated lung injury and the purpose of effective lung recruitment.

Full description

The traditional method, set PEEP according to PVC in ARDS mechanical ventilation, lacks morphological evaluation. For point-of-care lung ultrasound(POC-LUS) is non-invasive, real-time, visualization, no need transport patients, getting more and more attention in the ARDS treatment. It has been reported that LUS-RAS is a meaningful assessment in recruitment maneuver. This study will combine POC-LUS with PVC in set the initial peep, and then dynamic record LUS-RAS to feedback regulate PEEP. Using the POC-LUS and maximum oxygenation method to assess lung recruitment effect in experimental group and control group prospectively. The ventilator parameters, state of hemodynamic, arterial blood gas(ABG) in each group will be recorded; Statistical methods will be performed in term to understand the correlation.

Enrollment: 30 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patient aged 18 years and older
• ARDS patients with invasive mechanical ventilation

Exclusion criteria

• Intracranial hypertension
• Pneumothorax and mediastinal emphysema
• Severe hypoxemia (oxygenation index <100)
• Hemodynamic instability
• Chest deformity or surgical history
• Affect Lung-ultrasound conditions: subcutaneous emphysema, chest wound etc.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

Maximum Oxygenation

Active Comparator group

Description:

Using PVC to set the initial peep, check ABG real-time, and according to PaO2+PaCO2≥400mmHg whether or not to adjust maintain PEEP.

Treatment:

Diagnostic Test: Maximum Oxygenation

Lung Ultrasound Re-aeration Score

Experimental group

Description:

Combine POC-LUS with PVC in set the initial peep, and then dynamic record LUS-RAS to feedback regulate PEEP.

Treatment:

Device: Lung Ultrasound