Association Between Driving Transpulmonary Pressure and Extravascular Lung Water in Patients with ARDS
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Respiratory Distress Syndrome
- Sponsor
- Bicetre Hospital
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Association between the transpulmonary driving pressure and the extravascular lung water (EVLW)
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
Intubated patients with the acute respiratory distress syndrome (ARDS) are usually treated with protective ventilation limiting plateau pressure below 30 centimeter of water (cmH2O) and, if possible, a driving pressure under 15 cmH2O. However, these airway pressures might not reflect the actual pressure applied to the lung. Transpulmonary pressure is the difference between airway pressure and pleural pressure, the latter is estimated by the esophageal pressure, and so it better reflects the ventilatory induced lung injury (VILI).
One of the consequences of the VILI is a increase of pulmonary edema and it could be estimated by the extravascular lung water, obtained by trans-pulmonary thermodilution.
So it could exist a link between the driving trans-pulmonary pressure and the extravascular lung water.
Investigators
Tai PHAM
Principal Investigator
Bicetre Hospital
Eligibility Criteria
Inclusion Criteria
- •Acute respiratory distress syndrome (ARDS)
- •Monitoring with a transpulmonary thermodilution device
- •Esophageal pressure monitoring
Exclusion Criteria
- •Legal protection measures
- •Pregnancy
- •Contra-indications of esophageal catheter : esophageal varicose, severe coagulopathy
Outcomes
Primary Outcomes
Association between the transpulmonary driving pressure and the extravascular lung water (EVLW)
Time Frame: From inclusion up to hospital discharge (maximum day 60)
On the first day of patient's respiratory and hemodynamics monitoring, we will collect transpulmonary driving pressure and extra-vascular lung water values. We will calculate the correlation coefficient linking these two variables to assess if their association.
Secondary Outcomes
- Correlation between the extravascular lung water at admission and the ICU-mortality(From inclusion up to hospital discharge (maximum day 60))
- Influence of position on plateau pressure on transpulmonary pressure(From inclusion up to hospital discharge (maximum day 60))
- Influence of position on plateau pressure(From inclusion up to hospital discharge (maximum day 60))
- Correlation between the transpulmonary driving pressure at admission and the ICU-mortality(From inclusion up to hospital discharge (maximum day 60))
- Association between the transpulmonary driving pressure and the pulmonary vascular permeability index (PVPI)(From inclusion up to hospital discharge (maximum day 60))
- Influence of position on plateau pressure on intra-abdominal pressure(From inclusion up to hospital discharge (maximum day 60))
- Influence of position on plateau pressure on esophageal pressure(From inclusion up to hospital discharge (maximum day 60))