Pleural Strain by Speckle-Tracking Ultrasound: Feasibility and Driving Pressure Associations

Launched by FIRST AFFILIATED HOSPITAL OF WANNAN MEDICAL COLLEGE · Mar 28, 2025

Keywords

ClinConnect Summary

This clinical trial is studying a new ultrasound technique called "speckle tracking" to see how well it can measure the stretching of the lung lining (pleura) during breathing, especially for patients who are on ventilators. The goal is to help doctors adjust the settings on ventilators more safely to protect the lungs from damage, particularly in patients with serious lung conditions like Acute Respiratory Distress Syndrome (ARDS). By using this painless ultrasound method, doctors hope to monitor lung health in real time, which could lead to better care for patients in intensive care units (ICUs).

To participate in the study, you need to be an adult (18 years or older) who is critically ill and has a specific score indicating the severity of your condition. The trial is looking for patients who are either on a ventilator or receiving other types of oxygen support. If you join, a small probe will be placed on your chest for about 5-10 minutes to take videos of your lung movements without any discomfort. This information will help doctors tailor your treatment and could benefit future patients by improving ventilator management worldwide. Your privacy is protected, and taking part is completely voluntary.

Gender

ALL

Eligibility criteria

• • Phase 1: Feasibility Assessment in Non-Mechanically Ventilated Patients
• Inclusion Criteria:
• • Adult patients (≥18 years) admitted to the ICU with an APACHE II score \>8.
• • Non-mechanically ventilated patients (either spontaneously breathing or receiving only non-invasive oxygen therapy).
• Exclusion Criteria:
• • History of thoracic surgery or trauma.
• • Presence of pneumothorax or chest trauma (e.g., rib fractures, flail chest).
• • Pregnancy or age \<18 years.
• • Refusal to participate by the patient or legal representative.
• • Poor ultrasound image quality (e.g., unclear pleural visualization).
• • Phase 2: Feasibility Assessment in Mechanically Ventilated Patients
• Inclusion Criteria:
• • Adult patients (≥18 years) admitted to the ICU with an APACHE II score \>8.
• • Receiving invasive mechanical ventilation for \>24 hours.
• Exclusion Criteria:
• • History of thoracic surgery or trauma.
• • Presence of pneumothorax or chest trauma (e.g., rib fractures, flail chest).
• • Pregnancy or age \<18 years.
• • Requirement for high-frequency oscillatory ventilation.
• • Poor ultrasound image quality (e.g., pleural motion obscured by pleural effusion).
• • Phase 3: Correlation Analysis of Strain and Driving Pressure in Mechanically Ventilated Patients
• Inclusion Criteria:
• • Adult patients (≥18 years) admitted to the ICU with an APACHE II score \>8.
• • Receiving invasive mechanical ventilation for \>24 hours.
• • Tolerance to stepwise driving pressure adjustments (10, 15, and 20 cmH₂O, maintained for 10 minutes each).
• Exclusion Criteria:
• • History of thoracic surgery or trauma.
• • Presence of pneumothorax, chest trauma (e.g., rib fractures, flail chest), or significant patient-ventilator asynchrony.
• • Pregnancy or age \<18 years.
• • Requirement for high-frequency oscillatory ventilation.
• • Hemodynamic instability (mean arterial pressure \[MAP\] \<65 mmHg or requiring high-dose vasopressors).
• • Severe hypoxemia (PaO₂/FiO₂ \<100 mmHg), precluding safe adjustment of driving pressure.
• • Poor ultrasound image quality (e.g., loss of pleural strain signal).