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The aim of the COMIX-R study is to assess the short term physiological effects of 3 ventilation strategies for adult patients with ARDS admitted to intensive care unit
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dual Mode first | Experimental | Four consecutive steps (45 min per step) in the following order: APRV (A), Dual Mode (B) , APRV (A) and VAC (C). (ABAC) |
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| VAC fist | Experimental | Four consecutive steps (45 min per step) in the following order: APRV (A), VAC (C) , APRV (A) and Dual Mode (B). (ACAB) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ventilation strategy | Other | Patients are ventilated in randomised order with three different ventilation strategies: volume assist control (constant flow), Dual Mode or Airway Pressure Released Ventilation |
| Measure | Description | Time Frame |
|---|---|---|
| change of PaO2 (mmHg) | Arterial partial pressure of dioxygen Of note: As it is a physiological study, all the primary and secondary outcomes will be analyzed with the same importance. | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| -Respiratory rate variability | variability of rate (per minute) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -expiratory and inspiratory transpulmonary pressure | calculated with the esophageal pressure (cm H20) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Francois BELONCLE, CCU-AH | Angers teatching hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University hospital | Angers | 49100 | France |
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patients exposed to 3 ventilatory mode in 2 different possible orders
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| 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -ventilation distribution in the lungs | Electrical impedance tomography (EIT) assess distribution of tidal volume and of end-expiratory lung volume (EELV) (delta Z, IU) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -other arterial parameters of hematosis | pH, PaO2, PaCo2 (mmHg) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -Work of breathing (WOB) | calculated with esophageal pressure (Kg/m) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -Pressure time product (PTP) | -Pressure time product (PTP) calculated with esophageal pressure (cmH2O.s.min-1) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -P0.1 | pressure measured during the first 100 ms after an occlusion (cm H20) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -PEEPi | intrinsic positive end-expiratory pressure (cm H20) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| MAP | mean arterial pressure | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| HR | heart rate (beats per minute) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -Respiratory comfort | visual analogic scale | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -Patient-ventilator asynchronies | numbers of asynchronies analyzed on screen | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |
| -Tidal volume variability | variability of Tidal volume (mL) | 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes |