Physiological Studies in the Prone Position in Patients With ARDS
- Conditions
- Acute Respiratory Distress SyndromeMechanical VentilationProne Positioning
- Registration Number
- NCT06586736
- Lead Sponsor
- West China Hospital
- Brief Summary
The purpose of this study is to observe the changes of physiological indicators such as ventilation and oxygenation in the prone position of ARDS patients, to observe the change trend of each patient's indicators, and to observe whether different trends of indicators predict different prognosis of patients.
- Detailed Description
PP has been shown to effectively improve the prognosis of patients with severe ARDS, but not all patients with ARDS can benefit from PP, and the implementation of the PP has a certain clinical risks and side effects, we lack a convenient predictors to guide doctors to determine whether patients should implement the PP. Clinical usually observe the P/F improved as whether PP treatment effective reference, but there are literature points out that the rising P/F after PP can not predict the better prognosis. one of the mechanisms for ARDS patients benefit from PP is proved to be improve V/Q, the change of the V/Q may determine whether the PP treatment effectively is an important indicator. PaO2:FiO2 ratio was usually used to evaluate the effect of PP, but some studies did not support this conclusion. PP has been shown to change ventilation-perfusion ratio, dead space may be better physiological indicators, simplify dead space ratio and Ventilatory ratio can be easily accessed at bedside and is associated with mortality of patients with ARDS. The purpose of this study is to observe the predictive value of P/F, VD-etCO2/VT, and VR on the treatment effect of ARDS undergoing PP.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 100
- Intubated patients
- Undergoing mechanical ventilation
- Moderate to severe ARDS
- Undergoing prone positioning
- Age≥18 years old
- Pregnant
- Cardiac structural shunt
- Extracorporeal membrane oxygenation performed
- Undergo extracorporeal CO2 removal
- Pulmonary embolism
- Other situation that may affect the accuracy of PetCO2 monitoring
- Prone positioning session less than 10 hours
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method 28 days without mechanical ventilation From the date of enrollment to 28 days Days without mechanical ventilation support within 28 days after enrollment
- Secondary Outcome Measures
Name Time Method ICU mortality and in-hospital mortality From the date of enrollment until the date of discharge, assessed up to 1 year Prognostic measures will be recorded until discharge, such as ICU mortality and in-hospital mortality
Length of lCU stay and length of hospital stay From the date of enrollment until the date of discharge, assessed up to 1 year. Prognostic measures will be recorded until discharge, such as length of lICU stay and length of hospital stay in days.
Respiratory physiological parameters. From enrollment to Day 7. Respiratory physiological parameters are collected at each time point (before prone positioning , every 4 hours after prone positioning, and 4 hours after turn back to supine position), such as PaO2/FiO2。
Indicators related to dead space From enrollment to Day 7. Indicators related to dead space are collected at each time point (before prone positioning , every 4 hours after prone positioning, and 4 hours after turn back to supine position), such as VR and dead space ratio, which were calculated by predicted body weight, partial pressure of carbon dioxide and end-tidal carbon dioxide
Trial Locations
- Locations (1)
Department of Critical care medicine of West China Hospital
🇨🇳Chengdu, Sichuan, China