Personalized Ventilation Strategy Using Ventilation-Perfusion Matching and Lung Recruitability in Adults with Moderate-to-Severe ARDS

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 VQ 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.

Personalized Ventilation Based on Ventilation-perfusion Mismatch and Lung Recruitability