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We aims to investigate the effects of prone positioning and nitric oxide inhalation in adult patients who is diagnosed with COVID-19 associated acute respiratory distress syndrome by electrical impedance tomography.
The investigators aim to investigate the effects of prone positioning and nitric oxide inhalation in adult patients who is diagnosed with COVID-19 associated acute respiratory distress syndrome by electrical impedance tomography (EIT).
The EIT assessment is performed in patients ventilated in supine position, supine position with NO inhalation for 1 hour, prone position for 1 hour, prone position for 2 hours with NO inhalation for 1 hour, prone position for 3 hours, prone position for 16 hours, re-supine position for 3 hours. Arterial blood gas (ABG) analysis results, ventilator parameters and hemodynamic parameters are also recorded at each time point.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ventilation in supine position | Patients are ventilated in supine position. | ||
| Ventilation in supine position and NO inhalation | Patients are ventilated in supine position with NO inhalation for 1 hour. |
| |
| Ventilation in prone position for 1 hour | Patients are ventilated in prone position for 1 hour. |
| |
| Ventilation in prone position for 2 hours plus NO inhalation for 1 hour | Patients are ventilated in prone position for 1 hour followed by ventilation in prone position with NO inhalation for 1 hour. |
| |
| Ventilation in prone position for 3 hours | Patients are ventilated in prone position for 1 hour followed by ventilation in prone position with NO inhalation for 1 hour. Then they are ventilated in prone position alone for 1 hour. |
| |
| Ventilation in prone position for 16 hours |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| prone postion | Behavioral | ventilation at prone positioning |
|
| Measure | Description | Time Frame |
|---|---|---|
| oxygenation status | To evaluate the oxygenation parameters | 1 day |
| regional distribution of pulmonary perfusion | To evaluate the effect of prone positon and NO inhalation on pulmonary blood flow distribution. | 1 day |
| regional distribution of pulmonary ventilation | To evaluate the effect of prone positon and NO inhalation on pulmonary vetilation distribution. | 1 day |
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Inclusion Criteria:
Exclusion Criteria:
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adult patients who have COVID-19-associated acute respiratory distress syndrome
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ming Zhong, PhD | Contact | 021-65642662 | zhong.ming@zs-hospital.sh.cn |
| Name | Affiliation | Role |
|---|---|---|
| Ming Zhong, PhD | Fudan University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zhongshan Hospital, Fudan University | Recruiting | Shanghai | Shanghai Municipality | 200032 | China |
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D011024 | Pneumonia, Viral |
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Patients are ventilated in prone position for 1 hour followed by ventilation in prone position with NO inhalation for 1 hour. Then they are ventilated in prone position alone for 14 hours.
|
| Ventilation in re-supine position for 3 hours | Patients are ventilated in supine position for 3 hours followed by ventilation in prone position for 16 hours. |
|
| NO inhalation | Drug | NO inhalation at 20 ppm |
|
| D011014 |
| Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D014777 | Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |