Stepwise Positive End Expiratory Pressure Elevation For Lung Recruitment in Acute Respiratory Distress Syndrome (ARDS)

University of Alexandria

Status: Completed

Conditions: Acute Respiratory Distress Syndrome

Treatments: Procedure: Recruitment maneuver; Procedure: recruitment maneuver

Study type: Interventional

Funder types: Other

Identifiers

NCT01373905

Faculty of Medicine12.12.2006

Details and patient eligibility

About

Acute respiratory distress syndrome is a severe lung disease caused by a variety of direct and indirect issues. It is characterized by inflammation of the lung parenchyma leading to impaired gas exchange and persistent hypoxemia. This condition is often fatal, usually requiring mechanical ventilation. Recruitment maneuver aimed to enhance the effect of mechanical ventilation.The objective of this study was to compare safety and efficacy of two lung recruitment maneuvers.

Full description

In patients with acute respiratory distress syndrome (ARDS), protective lung strategy and positive end expiratory pressure (PEEP) therapy should be started as early as possible to avoid lung damage by high pressures, volumes and fraction of inspired oxygen (FiO2). Recruitment is a strategy aiming at re-expanding the collapsed lung tissue and then maintaining an adequate level of PEEP to prevent subsequent de-recruitment. The objective of this study was to compare safety and efficacy of two lung recruitment maneuvers (RM): stepwise PEEP elevation with determination of the alveolar collapsing pressure versus sustained lung inflation in ARDS patients

Enrollment: 24 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ARDS
• lung injury score more than 2.5
• on mechanical ventilation

Exclusion criteria

• hemodynamic instability
• left heart failure
• pneumothorax
• COPD
• restrictive lung disease

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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24 participants in 2 patient groups

Sustained lung inflation

Active Comparator group

Description:

recruitment was done using CPAP of 30 Cm/ H2o for 30 seconds

Treatment:

Procedure: Recruitment maneuver

Stepwise PEEP elevation

Active Comparator group

Description:

Recruitment was done using stepwise elevation of PEEP followed by determination of the alveolar collapsing pressure

Treatment:

Procedure: Recruitment maneuver