Personalized Ventilation Based on Ventilation-perfusion Mismatch and Lung Recruitability

Launched by ZHONGDA HOSPITAL · May 21, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how different levels of pressure in the lungs and body position can affect breathing in patients with moderate-to-severe Acute Respiratory Distress Syndrome (ARDS). ARDS is a serious condition that makes it hard for patients to breathe, often requiring mechanical ventilation (a machine to help them breathe). The researchers want to understand how personalized ventilation strategies can improve lung function and blood flow to the lungs, using a special imaging technique called electrical impedance tomography (EIT).

To be eligible for this study, participants must be at least 18 years old, be diagnosed with moderate-to-severe ARDS, and need invasive mechanical ventilation. They should also be planned to be placed on their stomach (a position known as prone) for better lung function. Patients who are pregnant, have severe instability in their blood pressure, or certain other medical conditions will not be included in the trial. Those who participate will be monitored closely to see how well their lungs respond to these personalized ventilation strategies, helping doctors learn more about how to improve care for ARDS patients in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. age ≥18 years
• • 2. Moderate-to-severe ARDS as per the 2023 ESICM definition
• • 3. Undergoing invasive mechanical ventilation
• • 4. Planned prone position based on the attending physicians' decisions
• • 5. Signed informed consent
• Exclusion Criteria:
• • 1. age ≥85 years
• • 2. Pregnancy
• • 3. Severe hemodynamic instability (\> 30% increase in vasopressors in the last 6 hours or norepinephrine \> 0.5 µg/kg/min)
• • 4. Clinically suspected elevated intracranial pressure (\>18 mm Hg)
• • 5. Bronchopleural fistula
• • 6. Contraindication to EIT monitoring (e.g. burns, pacemaker, thoracic wounds limiting electrode belt placement)
• • 7. Severe hypernatremia (\>170mmol/L)
• • 8. Re-admission of patients already enrolled in this study, or patients who are participating in other studies