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| Name | Class |
|---|---|
| French Society for Intensive Care | OTHER |
| Act For Chronic Diseases | OTHER |
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Patients suffering from Acute Respiratory Distress Syndrome (ARDS) with a prone position (PP) indication will benefit from measurements of renal resistive index, intra-abdominal pressure (IAP), urinary oxygen tension (uPO2) and ventilatory mechanics in supine position (baseline IAP), after 2 hours in PP at the current IAP value, thirty minutes after patients' abdomen suspension in order to resume baseline IAP and after patients' are turned back to supine position.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Prone position | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prone position | Other | Abdomen suspension in prone position |
|
| Measure | Description | Time Frame |
|---|---|---|
| change in renal resistive index (RRI) | RRI measurement will be performed on a right kidney arcuate/interlobar artery, with a high frequency Doppler probe. Three to five consecutive measures will be obtained then RRI computed according to the formula: (peak systolic velocity - end diastolic velocity)/peak systolic velocity). | At inclusion (in supine position), two hours after prone positioning, 30-minutes after the abdomen suspension maneuver |
| Measure | Description | Time Frame |
|---|---|---|
| change in renal medullary oxygen tension | urinary oxygen tension (uPO₂) will be measured via a fiber-optic luminescence optode inserted through the bladder catheter lumen | At inclusion (in supine position), two hours after prone positioning, 30-minutes after the abdomen suspension maneuver |
| ventilatory mechanics: transpulmonary pressure |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Grenoble University | Grenoble | 38000 | France |
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| D058186 | Acute Kidney Injury |
| D059325 | Intra-Abdominal Hypertension |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D051437 | Renal Insufficiency |
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| ID | Term |
|---|---|
| D016684 | Prone Position |
| ID | Term |
|---|---|
| D011187 | Posture |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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transpulmonary pressure will be measured at the end of inspiration and expiration and continuously recorded on a datalogger |
| At inclusion (in supine position), two hours after prone positioning, 30-minutes after the abdomen suspension maneuver |
| ventilatory mechanics: driving pressure | driving pressure will be measured at the end of inspiration and expiration and continuously recorded on a datalogger | At inclusion (in supine position), two hours after prone positioning, 30-minutes after the abdomen suspension maneuver |
| ventilatory mechanics: elastance | elastance will be measured at the end of inspiration and expiration and continuously recorded on a datalogger | At inclusion (in supine position), two hours after prone positioning, 30-minutes after the abdomen suspension maneuver |
| haematosis | arterial oxygen tension (PaO2) and arterial dioxide carbon tension (PaC02) | At inclusion (in supine position), two hours after prone positioning, 30-minutes after the abdomen suspension maneuver |
| Intra abdominal pressure | Intra abdominal pressure will be measured thanks to a dedicated nasogastric tube with two balloons (gastric pressure) | At inclusion (in supine position), two hours after prone positioning, 30-minutes after the abdomen suspension maneuver and two hours after patients are back in supine position |
| Persisting effect of IAP increase in prone position when patients are back in supine position on renal resistive index | RRI measurement will be performed on a right kidney arcuate/interlobar artery, with a high frequency Doppler probe. Three to five consecutive measures will be obtained then RRI computed according to the formula: (peak systolic velocity - end diastolic velocity)/peak systolic velocity). | Two hours after patients are back in supine position |
| Persisting effect of IAP increase in prone position when patients are back in supine position on urinary PO2 | urinary oxygen tension (uPO₂) will be measured via a fiber-optic luminescence optode inserted through the bladder catheter lumen | Two hours after patients are back in supine position |
| Persisting effect of IAP increase in prone position when patients are back in supine position on ventilatory mechanics: transpulmonary pressure | transpulmonary pressure will be measured at the end of inspiration and expiration and continuously recorded on a datalogger | Two hours after patients are back in supine position |
| Persisting effect of IAP increase in prone position when patients are back in supine position on ventilatory mechanics: driving pressure | driving pressure will be measured at the end of inspiration and expiration and continuously recorded on a datalogger | Two hours after patients are back in supine position |
| Persisting effect of IAP increase in prone position when patients are back in supine position on ventilatory mechanics: elastance | elastance will be measured at the end of inspiration and expiration and continuously recorded on a datalogger | Two hours after patients are back in supine position |
| Persisting effect of IAP increase in prone position when patients are back in supine position on haematosis | arterial oxygen tension (PaO2) and arterial dioxide carbon tension (PaC02) | Two hours after patients are back in supine position |
| Acute kidney injury | According to creatinine or diuresis criteria of Kidney Disease: Improving Global Outcomes (K-DIGO) classification | within 48 hours following prone position |
| D007674 |
| Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D003161 | Compartment Syndromes |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |