Effect of APRV vs. LTV on Right Heart Function in ARDS Patients: a Single-center Randomized Controlled Study

Launched by XIAOJING ZOU,MD · Jun 27, 2023

Keywords

ClinConnect Summary

This clinical trial is examining how two different types of mechanical ventilation—APRV (Airway Pressure Release Ventilation) and LTV (Low Tidal Volume)—affect the function of the right side of the heart in patients with Acute Respiratory Distress Syndrome (ARDS). ARDS can sometimes lead to problems with the right side of the heart, which can make recovery more difficult. The goal of the study is to see if using APRV can help improve heart function better than LTV in these patients, as well as reduce the risk of right heart complications.

To participate in this study, patients must be between 18 and 80 years old, diagnosed with ARDS, and currently receiving invasive mechanical ventilation. They should have certain breathing difficulties, like a low oxygen level, but must not have specific medical conditions that could interfere with the trial. If eligible, participants can expect to be randomly assigned to receive either APRV or LTV ventilation during their treatment. This study is important as it could help doctors determine the best approach to support patients' heart health while they recover from ARDS.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Patients who meet the 2012 Berlin ARDS diagnostic criteria and perform invasive mechanical ventilation 2, PEEP≥5cmH2O, oxygenation index ≤200mmHg 3. Tracheal intubation and mechanical ventilation were performed for less than 48h at the time of inclusion 4. Age ≥18 years and ≤80 years
• Exclusion Criteria:
• • 1.abdominal pressure≥20mmHg 2.BMI≥35kg/m2; 3. pregnant and lactating women 4.expected duration of invasive mechanical ventilation \< 72 hours 5. neuromuscular diseases known to require prolonged mechanical ventilation 6.severe chronic obstructive pulmonary disease, severe asthma, Interstitial lung disease 7.intracranial hypertension, 8.pulmonary bullae or pneumothorax, subcutaneous emphysema, or mediastinal emphysema, 9.extracorporeal membrane oxygenation or prone position ventilation on admission to the ICU 10. uncorrected shock of various types and refractory shock 11.pulmonary embolism 12.severe cardiac dysfunction (New York Heart Association class III or IV). Acute coronary syndrome or sustained ventricular tachyarrhythmia), right heart enlargement due to chronic cardiopulmonary diseases, cardiogenic shock or after major cardiac surgery 13.poor cardiac sound window, unable to obtain cardiac ultrasound images 14.no informed consent was signed