Trans Thoracic Manipulation of Ventilation/Perfusion: the V/Q System

Launched by EMORY UNIVERSITY · Apr 28, 2020

Keywords

ClinConnect Summary

Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surfaced at the end of 2019, transmission has been rapid and particularly lethal. Death is most commonly due to ARDS which has been quoted as occurring in up to 42% of patients. The rapid lethality of the COVID-19 has emphasized the limitations of currently available therapies in the Intensive Care Unit. Traditional mechanical ventilator support, the use of inhaled and systemic pulmonary vasodilatory drugs, invasive monitoring, proning and extracorporeal membrane oxygenation (ECMO) to name a few, are all voracious consum...

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Eligibility criteria

• Inclusion Criteria:
• • Presentation with acute respiratory distress syndrome (ARDS) requiring intubation with mechanical ventilator support. ARDS will be defined by the ratio of the partial pressure of oxygen in the patient's arterial blood (PaO2) to the fraction of oxygen in the inspired air (FiO2) as being \< 300.
• • Ability of a Legally Authorized Representative (LAR) to provide consent on behalf of the patient.
• Exclusion Criteria:
• • Presence of cutaneous wounds that would be compromised by the Vest including stage 3 or greater pressure ulcers and the presence of actively treated burns
• • Patients with pre-existing pulmonary hypertension and pulmonary fibrosis
• • Bony chest trauma within the last 10 days
• • Contraindications to esophageal manometry including recent esophageal trauma or surgery
• • Abdominal compartment syndrome
• • Active or recent gross hemoptysis
• • Elevated intracranial pressure \>20 mmHg
• • LAR refusal to participate
• • Severe Scoliosis
• • Morbidly obese (BMI \>37)
• • Pregnant women
• • Unable to maintain oxygen saturation \> 88%