Association Between Driving Transpulmonary Pressure and Extravascular Lung Water in Patients with ARDS
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- Association between the transpulmonary driving pressure and the extravascular lung water (EVLW)
研究概览
简要总结
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
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
- •Acute respiratory distress syndrome (ARDS)
- •Monitoring with a transpulmonary thermodilution device
- •Esophageal pressure monitoring
排除标准
- •Legal protection measures
- •Pregnancy
- •Contra-indications of esophageal catheter : esophageal varicose, severe coagulopathy
结局指标
主要结局
Association between the transpulmonary driving pressure and the extravascular lung water (EVLW)
时间窗: 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.
次要结局
- 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))
研究者
Tai PHAM
Principal Investigator
Bicetre Hospital