Selective Lung Recruitment in Moderate to Severe ARDS : a Pilot Study (SRIMSA)

Caen University Hospital

Status: Not yet enrolling

Conditions: Acute Respiratory Distress Syndrom

Treatments: Procedure: Selective lung recruitment

Study type: Interventional

Funder types: Other

Identifiers

NCT06609629

2024-A00005-42

Details and patient eligibility

About

Acute respiratory distress syndrome (ARDS) is an acute condition affecting the lung after clinical aggression ( infectious process, pancreatitis, acute inflammatory event). This condition lead to major breathlessness due to the incapacity to properly oxygenize the boby because of lung lesions. Invasive mechanical ventilation is frequently required to grant sufficient oxygenation to the body. Unfortunately, while it allows oxygenation, mechanical ventilation can cause arms to the lung because of the mechanical power it delivers to the lung and create ventilation induced lung injuries (VILI). To reduce this risk, ventilator settings have been protocolized aiming to reduce the lung volume administered to the lung. It is effective to control the VILI but oxygenation may be insufficient under those protective parameters. To correct this lack of oxygenation practicians use recruiting maneuvers when a transient increase of lung volume administered to the lung to open collapse parts of the lung. Those maneuvers can cause barotrauma and provoke pneumothorax or decrease the heart flow. This study aim to assess the feasibility of selective recruitment maneuvers to increase oxygenation while reducing the risk of recruitment maneuvers.

Briefly, a dedicated bronchial blocker is introduce in a lower part of the lung, a balloon attached to the catheter is expended isolating a part of the lung and a recruiting pressure is administered through the lumen of the catheter to selectively expend the isolated part of the lung.

After the selected recruitment maneuver, the investigators will assess the expansion of the lung with a CT-scanner.

Enrollment: 10 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• acute ARDS according Berlin definition and a PaO2/FiO2 ratio inferior to 200
• patient under sedation and muscular blockade
• postero-basal consolidation on CT or pulmonary ultrasound
• affiliated to the French social insurance system

Exclusion criteria

• hemodynamic instability
• pregnancy
• patient under guardianship

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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10 participants in 1 patient group

interventional arm

Experimental group

Description:

This is a feasibility study. One arm of 10 patients is needed

Treatment:

Procedure: Selective lung recruitment