Actively Recruiting
End-expiratory Transpulmonary Pressure-guided vs Electrical Impedance Tomography-guided PEEP Titration Methods in Patients With Intra-abdominal Hypertension Combined With Acute Respiratory Distress Syndrome: a Randomized Crossover Controlled Study
Led by XiaoJing Zou,MD · Updated on 2025-11-21
20
Participants Needed
1
Research Sites
60 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
This study aims to adopt a randomized crossover design to compare the effects of end-expiratory transpulmonary pressure-guided PEEP titration and EIT-guided PEEP titration on local lung ventilation, shunt, dead space, and ventilation-perfusion (V/Q) ratio as monitored by EIT. Additionally, it will evaluate their impact on respiratory mechanics, chest wall mechanics, mechanical power, hemodynamics, gas exchange, intra-abdominal pressure, abdominal perfusion pressure, and renal perfusion. By identifying an optimal PEEP titration strategy for patients with intra-abdominal hypertension (IAH) and acute respiratory distress syndrome (ARDS), this study aims to develop a mechanical ventilation approach that maintains lung recruitment and minimizes lung injury while avoiding adverse effects on other organs. The findings could facilitate the clinical application of this strategy and benefit a broader population of patients with IAH and ARDS.
CONDITIONS
Official Title
End-expiratory Transpulmonary Pressure-guided vs Electrical Impedance Tomography-guided PEEP Titration Methods in Patients With Intra-abdominal Hypertension Combined With Acute Respiratory Distress Syndrome: a Randomized Crossover Controlled Study
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age between 18 and 80 years
- Diagnosed with intra-abdominal hypertension of 12 mmHg or higher
- Meets the 2023 global diagnostic criteria for acute respiratory distress syndrome
- PaO2/FiO2 ratio of 150 or less
- Within 36 hours of starting invasive mechanical ventilation
- Patient or family has agreed and signed informed consent
You will not qualify if you...
- Age under 18 or over 80 years
- Uncorrected shock of any type
- Chronic obstructive pulmonary disease, interstitial lung disease, pulmonary embolism, right heart failure, pulmonary hypertension, or severe cardiac arrhythmia
- Pneumothorax, bronchopleural fistula, lung surgery within the last 2 weeks
- Receiving non-invasive ventilation or high-flow nasal oxygen
- Contraindications to EIT such as large chest skin injuries, infections, pacemaker or defibrillator implants, pneumothorax, mediastinal emphysema, or massive pleural effusion
- Esophageal obstruction, perforation, severe variceal bleeding, or recent upper gastrointestinal surgery preventing esophageal catheter placement
- Diaphragmatic hernia, thoracic deformity, or obvious pulmonary hernias
- Prolonged blood clotting times or active nasopharynx bleeding
- Severe neurological diseases like intracranial hypertension or neuromuscular disease
- Pregnant or breastfeeding women
- Planned treatment with ECMO
- Re-admission to ICU after prior inclusion in this study or participation in other clinical trials
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 1 location
1
Wuhan Union Hospital
Wuhan, Hubei, China
Actively Recruiting
Research Team
X
Xiaojing Professor
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
CROSSOVER
Primary Purpose
SUPPORTIVE_CARE
Number of Arms
2
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