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The aim of the this study is to assess the short term physiological effects of 3 ventilation strategies for adult patients with ARDS admitted to intensive care unit.
Two of those strategies are based on electrical impedance tomography (EIT) monitoring.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A-B-A-C | Experimental | Four consecutive steps (45 min per step) are tested in the following order: Peep titration strategy according to Express method (A) - Peep titration strategy according to overdistension and collapse estimation (B) - Peep titration strategy according to Express method (A) - Peep titration strategy according to estimation of lung inhomogeneity (C) |
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| A-C-A-B | Experimental | Four consecutive steps (45 min per step) are tested in the following order: Peep titration strategy according to Express method (A) - Peep titration strategy according to estimation of lung inhomogeneity (C) - Peep titration strategy according to Express method (A) - Peep titration strategy according to overdistension and collapse estimation (B) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ventilation strategy | Other | Patients are ventilated in randomized order with three different ventilation strategies (A,B and C) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in PaO2 (mmHg) | As it is a physiological study, all the outcomes will be analyzed with the same importance! | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Change in PaCO2 (mmHg) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Plateau pressure (cmH2O) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Angers | Angers | 49100 | France |
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We use a crossover sequential model, with all 3 strategies tested in both arms.
A reference strategy, based on the Express method (PEEP level adjusted to reach a plateau pressure of 28-30 cmH2O), is applied at the begining of the study and during a wash-out period (between the 2 periods of application of the 2 EIT-based strategies).
The 2 EIT-based strategies are applied in a randomized order.
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As it is a physiological study, all the outcomes will be analyzed with the same importance
| Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Positive end expiratory pressure (cmH2O) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Expiratory and inspiratory transpulmonary pressure (cmH2O) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Regional ventilation distribution (%) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Center of ventilation (%) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Overdistension and collapsus (%) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Global and regional end expiratory lung impedance changes (IU) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| End expiratory lung volume (mL) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Blood pressure (mmHg) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Heart rate (bpm) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| Cardiac output (L/min) | As it is a physiological study, all the outcomes will be analyzed with the same importance | Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes |
| ID | Term |
|---|---|
| D055371 | Acute Lung Injury |
| ID | Term |
|---|---|
| D055370 | Lung Injury |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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