Gas Exchange Derangement Physiopathology and Response to Different Levels of Positive End-expiratory Pressure in Critically Ill Patients With COVID-19
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 14
- 试验地点
- 2
- 主要终点
- Shunt at three different levels of positive end expiratory pressure (PEEP)
研究概览
简要总结
The study was designed to understand the pathophysiology of gas exchange derangement in critically ill patients with COVID-19. Specifically we will evaluate the effect of 3 different levels of positive end-expiratory pressure (PEEP) and two different levels of inspiratory oxygen fraction (FiO2) on gas exchange by analyzing shunt and dead space. Furthermore, complete respiratory mechanics and distribution of ventilation and perfusion by electrical impedance tomography will be assessed at each level of PEEP.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients admitted in intensive care unit for COVID-19 related Acute Respiratory Distress Syndrome (ARDS) requiring invasive mechanical ventilation
排除标准
- •Pregnancy
- •Hemodynamic instability (80-90 mmHg increase or 30-40 mmHg decrease systolic arterial pressure compared to baseline value or need of vasopressors to maintain systolic blood pressure higher than 85 mmHg or electrocardiogram evidence of ischemia/arrhythmias)
- •Presence of pneumothorax and/or pneumomediastinum
- •Contraindications to Electrical Impedance Tomography (pacemaker, implantable cardioverter defibrillator, thoracic drainages)
结局指标
主要结局
Shunt at three different levels of positive end expiratory pressure (PEEP)
时间窗: 30 minutes after change of positive end expiratory pressure (PEEP) level
Shunt measured by arterial and mixed venous blood samples at each level of PEEP
次要结局
- Ventilation/perfusion at three different levels of positive end expiratory pressure (PEEP) assessed by electrical impedance tomography (EIT)(30 minutes after change of positive end expiratory pressure (PEEP) level)
- Respiratory mechanics at three different levels of positive end expiratory pressure (PEEP)(30 minutes after change of positive end expiratory pressure (PEEP) level)
- Dead space at three different levels of positive end expiratory pressure (PEEP)(30 minutes after change of positive end expiratory pressure (PEEP) level)
- Shunt and dead space at two different levels of inspiratory oxygen fraction for each level of positive end expiratory pressure (PEEP)(30 minutes after change of positive end expiratory pressure (PEEP) level)
研究者
Giacomo Grasselli
MD, Professor
Policlinico Hospital