Ventilation-Perfusion Matching in Early-stage Prone Position Ventilation

Completed

• Conditions: Acute Respiratory Distress Syndrome

• Registration Number: NCT05816928
• Lead Sponsor: Peking Union Medical College Hospital

Brief Summary

Prone positioning has been widely used in critical care medicine to improve oxygenation in patients with acute respiratory distress syndrome (ARDS). This study aimed to compare the effect of pronation on lung ventilation-perfusion matching between COVID19-associated acute respiratory distress syndrome (CARDS) and ARDS from other etiologies (non-CARDS) using electrical impedance tomography (EIT).

Detailed Description

In this prospective study, both COVID19-associated ARDS (CARDS) patients and patients with ARDS from other etiologies (non-CARDS) were enrolled. Electrical impedance tomography (EIT) was used to evaluate the changes in ventilation and perfusion between supine and prone positions. Baseline values of the area of DeadSpace, shunt, ventilation-perfusion matching (VQmatch) were identified at the time of enrollment. Within the defined VQmatch region, the global inhomogeneity index (VQmatch-GI) was calculated to assess the degree of uniformity within the region. Prone position was applied immediately after the baseline data were collected. After 2 hours of proning, another EIT examination was conducted. Parameters such as DeadSpace, shunt, VQmatch, and other common measurements before and after pronation were taken and compared to evaluate the effect of prone positioning on CARDS and non-CARDS patients.

Study Timeline

• Study Start: 2021-01-12
• Primary Completion: 2021-04-12
• Study Completion: 2021-04-12
• Status Verified: 2023-04
• Study First Submitted: 2023-04-05
• Study First Submitted QC: 2023-04-17
• Last Update Submitted: 2023-04-17
• Study First Posted: 2023-04-18
• Last Update Posted: 2023-04-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 29

Inclusion Criteria

• Above the age of 18
• Diagnosed with ARDS based on the Berlin Definition of ARDS
• Under mechanical ventilation

Exclusion Criteria

• Contraindications to EIT examination and prone position
• Refusal of signing the informed consent

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Shunt	3 months	Shunt will be assessed using electrical impedance tomography
DeadSpace	3 months	The area of Deadspace will be assessed using electrical impedance tomography
Ventilation-perfusion matching (VQmatch)	3 months	VQmatch will be assessed using electrical impedance tomography
Global inhomogeneity index (VQmatch-GI)	3 months	Within the defined VQmatch region assessed by electrical impedance tomography, the global inhomogeneity index (VQmatch-GI) was calculated to assess the degree of uniformity within the region.

Secondary Outcome Measures

Name	Time	Method
Center of Ventilation (CoV)	3 months	The center of ventilation of the lungs is assessed by electrical impedance tomography before and after prone positioning.
Standard deviation of regional ventilation delay	3 months	The standard deviation of regional ventilation delay of the lungs is assessed by electrical impedance tomography before and after prone positioning.
Perfusion	3 months	The perfusion of the lungs is assessed by electrical impedance tomography before and after prone positioning.
Ventilation	3 months	The ventilation of the lungs is assessed by electrical impedance tomography before and after prone positioning.

Trial Locations

Locations (1)

PUMC; 🇨🇳 Beijing, Beijing, China