Titration of Positive End-expiratory Pressure: Comparison Between Manual Thoracic or Abdominal Compression and Electrical Impedance Tomography

Titration of Positive End-expiratory Pressure: Comparison Between Manual Thoracic or Abdominal Compression and Electrical Impedance Tomography

Patients with acute respiratory distress syndrome are placed on mechanical ventilation, and the adjustment of ventilator parameters is an important step in their care, in particular positive expiratory pressure, applied at the end of breathing.

The goal of this study is to learn if continuous anterior chest compression works as well as electrical impedance tomography for positive expiratory pressure titration.

Researchers will compare the two methods for each patient, in a randomly determined order : continuous anterior chest compression and electrical impedance tomography.

Participants will :

• have a pep titration with both techniques
• be included in the study for 28 days

Personalizing the PEEP level is an important step in ventilator adjustment in ARDS patients.

The investigators have developed a simple, low-cost method to detect overdistension of the lung, consisting of applying manual compression to the anterior aspect of the patient's thorax, and observing whether the ventilator pressure increases or decreases.

The investigators hypothesize that with this simple method it is possible to determine the PEEP level which corresponds to that determined with EIT.

Inclusion Criteria:

• Age ≥ 18 years
• Moderate to severe ARDS according to the Berlin criteria
• Patient receiving sedation and continuous curarization
• Free and informed consent from the patient or their loved one

Exclusion Criteria:

• ECMO
• Pneumothorax
• Chest trauma in the last 3 months
• Uncontrolled shock (noradrenaline > 5 mg/h)
• Pregnant or breastfeeding woman
• Protected adult within the meaning of the law
• Lack of social security
• Patient under AME