Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography.
Eduardo L V Costa, João Batista Borges, Alexandre Melo...
https://pubmed.ncbi.nlm.nih.gov/19255741Actively Recruiting
Phase Not Applicable
Age: 18Years +
All Genders
ID06733168
The Impact of PEEP-guided Electrical Impedance Tomography on Oxygenation and Pulmonary Mechanics in Moderate-to-severe ARDS
Led by Vietnam Military Medical University · Updated on 2024-12-13
76
Participants Needed
1
Research Sites
2 weeks
Total Duration
On this page
Sponsors
V
Vietnam Military Medical University
Lead Sponsor
H
Hanoi Medical University
Collaborating Sponsor
AI-Summary
What this Trial Is About
This research aims to compare two methods of setting positive end-expiratory pressure (PEEP) in adults with moderate to severe acute respiratory distress syndrome (ARDS) who require mechanical ventilation. ARDS is linked to high mortality, and while mechanical ventilation is essential, it can cause lung injury. The study focuses on whether using electrical impedance tomography (EIT) to guide PEEP settings improves blood oxygenation and lung function compared to the traditional low FiO2-PEEP table approach. Participants will be randomly assigned to one of two groups. The intervention group will have PEEP adjusted using EIT guidance with a stepwise decremental PEEP trial, which involves increasing and then gradually decreasing PEEP while monitoring lung overdistension and collapse. The control group will have PEEP set according to the low FiO2-PEEP table based on standard ARDSnet protocol. Both groups will receive lung-protective ventilation with sedation and neuromuscular blockade to synchronize with the ventilator. Throughout the study, researchers will monitor blood oxygen levels and lung mechanics daily for seven days. Additional assessments include ventilator-free days, length of intensive care unit stay, mechanical ventilation duration, complications such as pneumothorax, rescue therapy use, organ failure scores, and mortality up to two months. Patient safety is closely observed during PEEP adjustments, with criteria to stop procedures if significant blood pressure or oxygen drops occur. The study duration for each participant includes these daily assessments over a week and follow-up for two months.
CONDITIONS
Brief Title
The Impact of PEEP-guided Electrical Impedance Tomography on Oxygenation and Pulmonary Mechanics in Moderate-to-severe ARDS
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
- Age 18 years or older
- Intubated patients with moderate to severe ARDS defined by PaO2/FiO2 ratio of 200 mmHg or less
- Patients receiving continuous sedation with or without paralysis
You will not qualify if you...
- Presence of undrained or newly developed pneumothorax
- Unstable hemodynamics with mean arterial pressure below 60 mmHg unresponsive to treatment and/or heart rate below 60 bpm
- Contraindications to EIT including pacemakers, automatic external defibrillators, recent chest trauma, or chest surgery preventing EIT belt use
- Pregnancy
- Severe neuromuscular disease
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Up to 28 days
Participants receive lung-protective ventilation with PEEP settings determined either by electrical impedance tomography guidance or by the low FiO2-PEEP table based on the ARDSnet protocol. Ventilator parameters are managed according to the ARDSnet strategy, with active adjustment of PEEP to optimize oxygenation and pulmonary mechanics.
Daily assessments for up to 7 days with ongoing monitoring up to 28 days
Follow-up
Duration - Up to 2 months
Participants are monitored for clinical outcomes including ventilator-free days, length of ICU stay, complications, and mortality up to 2 months after treatment.
Periodic assessments including mortality and clinical status
Trial Site Locations
Total: 1 location
1
Intensive Care Center, Bach Mai Hospital
Hanoi, Vietnam
Actively Recruiting
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Research Team
T
Trung Van Dinh, MD
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Electrical Impedance Tomography in Acute Respiratory Distress Syndrome Management.
Jose Victor Jimenez, Andrew J Weirauch, Christopher A Culter...
https://pubmed.ncbi.nlm.nih.gov/35607967A New Global Definition of Acute Respiratory Distress Syndrome.
Michael A Matthay, Yaseen Arabi, Alejandro C Arroliga...
https://pubmed.ncbi.nlm.nih.gov/37487152The impact of PEEP-guided electrical impedance tomography on oxygenation and respiratory mechanics in moderate-to-severe ARDS: a randomized controlled trial.
Dinh Van Trung, Bui Thi Huong Giang, Dang Quoc Tuan...
https://pubmed.ncbi.nlm.nih.gov/41318662