Assessment of the Effects of Prone Positioning on Ventilation Homogenization in ARDS Patients by the Phase III Slope of the Volumetric Capnography

What this Trial Is About

Researchers are evaluating the effects of prone positioning on improving ventilation distribution in patients with Acute Respiratory Distress Syndrome (ARDS) who are intubated and mechanically ventilated due to respiratory failure. This observational study focuses on understanding how turning patients onto their stomachs affects lung function, particularly looking at the slope of the volumetric capnography phase III, which relates to ventilation homogenization. The study is sponsored by Istanbul University - Cerrahpasa and involves standard care procedures for ARDS patients. Participants will undergo prone positioning, where they are turned onto their stomachs and remain in this position for at least 16 hours and up to 24 hours, following ARDS guidelines. Before and after this intervention, measurements including low-flow pressure volume curves, airway opening pressure, and recruitment-to-inflation ratios will be assessed to optimize positive end-expiratory pressure. The phase III slope of the volumetric capnograph will be recorded at four time points: before prone positioning, immediately after, at the end of the prone cycle, and after returning to the supine position. During the study, patients will be closely monitored with several lung function assessments, including correlation measures between the phase III slope and oxygenation indices like PaO2/FiO2 ratio. Data collection will occur at specific intervals aligned with the prone positioning duration. The primary outcome centers on changes in the phase III slope after prone positioning. The study period extends up to 24 hours of prone positioning with ongoing observations to understand ventilation improvements in severe ARDS cases.

Change in the Phase III Slope of the Volumetric Capnography by Prone Positioning in Acute Respiratory Distress Syndrome