Using Electrical Impedance Tomography to Guide Positive End-Expiratory Pressure in Adults with Trauma-Related or Postoperative Acute Respiratory Distress Syndrome

What this Trial Is About

Researchers are evaluating the use of electrical impedance tomography EIT to guide positive end-expiratory pressure PEEP settings in patients with moderate to severe acute respiratory distress syndrome ARDS following trauma or major surgery. ARDS can be a serious complication requiring mechanical ventilation, but improper ventilator settings may worsen lung injury. This study aims to compare EIT-guided PEEP optimization with the conventional low oxygen and PEEP strategy to improve oxygen levels and respiratory function. The study randomly assigns adult patients to two groups. One group receives PEEP adjustments based on EIT, a bedside imaging device that monitors lung ventilation in real time. This involves sedation, airway suctioning, and a stepwise reduction of PEEP while monitoring lung collapse and overdistension to find the optimal PEEP level. The control group receives PEEP settings according to standard ARDS Network guidelines using a low oxygen and PEEP table. Both groups follow recommended ventilation and oxygenation protocols. Participants will be monitored for oxygenation and lung mechanics at baseline and daily for four days. Secondary measures include survival at 28 days, ventilator-free days, ICU and hospital stay lengths, barotrauma occurrence, use of rescue therapies, and organ function scores. Safety assessments include monitoring for blood pressure drops, oxygen saturation, and arrhythmias during PEEP titration. The trial will continue until December 2026, with comprehensive evaluations to assess the effects of EIT-guided PEEP on clinical outcomes in ARDS patients after trauma or surgery.

EIT-Guided PEEP Optimization in Trauma and Postoperative ARDS