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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PEEP titrations | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EIT | Device | Two PEEP titrations monitored by EIT will be performed, each with the electrode belt positioned at a different chest height (2nd intercostal space or 5th intercostal space). The order will be drawn at random. |
| Measure | Description | Time Frame |
|---|---|---|
| Impact of the position of the electrode belt on the results of PEEP titration by EIT. | Optimal PEEP determined by PEEP titration using the crossing point method. | Day 0 |
| Measure | Description | Time Frame |
|---|---|---|
| Impact of the existence of intra-tidal recruitment on the discordance between PEPEIT and PEPCRS | Variability of the impedance variation during insufflation of the tidal volume ("tidal impedance variation) during titration measured by the relative interquartile coefficient (Q3-Q1)/median | Day 0 |
| Factors associated with a discordance between PEPEIT and PEPCRS |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Samuel Tuffet, MD | Contact | +33(0)478618209 | stuffet@saintjosephsaintluc.fr | |
| Fanny Doroszewski, Mrs | Contact | +33(0)478618398 | fdoroszewski@saintjosephsaintluc.fr |
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Once the patient is included in the research, two PEEP titrations monitored by EIT will be performed, each with the electrode belt positioned at a different chest height. The order will be drawn at random.
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Variability of the impedance variation during insufflation of the tidal volume ("tidal impedance variation) during titration measured by the relative interquartile coefficient (Q3-Q1)/median |
| Day 0 |
| Discrepancy between compliance measured according to impedance and compliance measured according to exhaled volume | Regional ventilation delay (RVD) | Day 0 |