New Lung Ventilation Strategies Guided by Transpulmonary Pressure in VV-ECMO for Severe ARDS

Rui Wang

Status: Completed

Conditions: Respiratory Distress Syndrome, Adult

Treatments: Device: New lung ventilation strategy; Device: Conventional ventilation strategy

Study type: Interventional

Funder types: Other

Identifiers

NCT02439151

2014-KE-143

Details and patient eligibility

About

Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with severe acute respiratory distress syndrome (ARDS). But how to choose mechanical ventilation strategy is still not clear for severe ARDS patients supported by ECMO. Our previous work found that, compared to the traditional "lung rest" strategy, transpulmonary pressure guide new lung ventilation strategy can better maintain lung volume reduction lung collapse, atelectasis occurs. The severe ARDS patients receiving ECMO therapy were randomized divided into a new ventilation strategy group and the conventional ventilation strategy group. The new ventilation strategy is transpulmonary pressure guide ventilator setting method, and the conventional ventilation strategy is Extracorporeal Life Support Organization (ELSO) guide ventilation method. Compare the difference between the two groups of patients in lung injury, and explore the lung protection mechanism of new lung ventilation strategies guided by transpulmonary pressure. Our research group considered that transpulmonary pressure guide new lung ventilation strategy can provide more effective lung protection. And it will be further used in clinical work.

Enrollment: 104 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ARDS cause reversible;
• Pure oxygen is given, but PaO2/FiO2<80;
• P(A-a)O2>600mmHg;
• Murray score≥3.0;
• pH<7.2;

Exclusion criteria

• peak inspiratory pressure>30cmH2O;
• high FiO2>0.8;
• ventilation>7 days;
• contraindication to heparinization;
• non-reversible central nervous system injury
• chronic disease with a short life expectancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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104 participants in 2 patient groups

New Strategy

Experimental group

Description:

New Strategy: use transpulmonary pressure guide new lung ventilation strategy in ECMO for severe ARDS patients

Treatment:

Device: New lung ventilation strategy

Conventional Strategy

Other group

Description:

Conventional Strategy: use conventional ventilation strategy (ELSO guide ventilation strategy) in ECMO for severe ARDS patients

Treatment:

Device: Conventional ventilation strategy