Impact of Belt Position on the Results of PEEP Titration by EIT During ARDS

Impact of Belt Position on the Results of PEEP Titration by Electrical Impedance Tomography During Acute Respiratory Distress Syndrome

ARDS is a frequent reason for hospitalization in intensive care. In order to improve its management, doctors seek to limit the mechanical ventilation-induced injuries (VILI) that can occur. PEEP is a parameter that plays a role in the appearance of VILI, and its adjustment can be optimized by EIT. The EIT is a non-invasive, non-irradiating, real-time monitoring device, today widely used for the optimization of ventilation in patients intubated for ARDS. The positioning of the EIT belt at different chest heights could influence the result of the PEEP titration.

The aim of this study is to test the hypothesis that the position (2nd intercostal space or 5th intercostal space) of the EIT (Electrical Impedance Tomography) belt significantly influences the result of PEEP (Positive Expiratory Pressure) titration.

Inclusion Criteria:

• Occurrence of moderate to severe ARDS (PaO2/FiO2 ratio ≤ 200 mmHg) within 72 hours following intubation
• Criteria for moderate to severe ARDS for less than 72 hours
• Passive ventilation in controlled assisted ventilation (no spontaneous ventilation)
• Consent of next of kin

Exclusion Criteria:

• Age < 18 years
• ECMO
• Pneumothorax
• Pacemaker or implantable defibrillator
• Chest trauma in the last 3 months
• Skin peeling (Burned, Lyell)
• Intracranial hypertension
• Uncontrolled shock (noradrenaline >5 mg/h)
• Pregnant woman
• Adult patient protected within the meaning of the law
• Lack of social security