Actively Recruiting
Personalized Ventilatory Strategy Based on Ventilation-perfusion Mismatch and Lung Recruitability in Moderate-to-severe ARDS Patients
Led by Zhongda Hospital · Updated on 2026-02-03
40
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are investigating how different levels of positive end-expiratory pressure (PEEP) and body positions affect lung ventilation and blood flow matching in patients with moderate-to-severe acute respiratory distress syndrome (ARDS). ARDS causes poor matching of air and blood flow in the lungs, which can worsen lung injury. This observational study aims to understand how lung recruitability influences the benefits of PEEP and positioning on lung function. Participants will be deeply sedated and paralyzed while receiving protective mechanical ventilation. They will experience four different conditions in sequence: low PEEP in supine position, high PEEP in supine position, low PEEP in prone position, and high PEEP in prone position. Lung recruitability will be assessed by changing PEEP levels and measuring the recruitment-inflation ratio. Electrical impedance tomography (EIT) will be used to monitor regional lung ventilation and perfusion during these conditions. During the study, researchers will collect data including arterial blood gases, respiratory and hemodynamic parameters, and EIT measurements after each change in ventilator settings and position. The primary measure is the percentage of ventilation-perfusion matching (V/Q match%). Secondary measures include dead space percentage, shunt percentage, respiratory compliance, and oxygenation ratio. The total monitoring period occurs within 24 hours. Patient care decisions such as timing of prone positioning are made by the clinical team throughout the study.
CONDITIONS
Brief Title
Personalized Ventilation Based on Ventilation-perfusion Mismatch and Lung Recruitability
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age 18 years or older
- Diagnosed with moderate-to-severe acute respiratory distress syndrome (ARDS) as defined in 2023
- Receiving invasive mechanical ventilation
- Prone positioning planned by attending physicians
- Signed informed consent
You will not qualify if you...
- Age 85 years or older
- Pregnancy
- Severe hemodynamic instability (over 30% increase in vasopressors in last 6 hours or norepinephrine over 0.5 g/kg/min)
- Clinically suspected elevated intracranial pressure (greater than 18 mm Hg)
- Bronchopleural fistula
- Contraindications to EIT monitoring such as burns, pacemaker, or thoracic wounds limiting electrode belt placement
- Severe hypernatremia (over 170 mmol/L)
- Re-admission of patients already enrolled or participation in other studies
AI-Screening
AI-Powered Screening
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Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Screening and enrollment occur together in the intensive care setting
Duration - Up to 24 hours
Participants undergo ventilation and perfusion assessments using electrical impedance tomography (EIT) and blood gas analysis to evaluate ventilation-perfusion mismatch and lung recruitability under different ventilator settings and body positions.
Continuous monitoring and measurements during 4 ventilatory conditions in the intensive care unit
Duration - Up to 24 hours
Participants are monitored throughout the study period with data collected on ventilation-perfusion matching and respiratory parameters until study completion.
Ongoing monitoring during routine intensive care
Trial Site Locations
Total: 1 location
1
Zhongda Hospital, Southeast University
Nanjing, Jiangsu, China, 210009
Actively Recruiting
Research Team
F
Fengmei Guo, PhD, MD
Z
Zhiqian Zha, MM
How is the study designed?
Study Type
OBSERVATIONAL
Masking
N/A
Allocation
N/A
Model
N/A
Primary Purpose
N/A
Number of Arms
0
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