transpulmonary pressure guided ventilation in ARDS

Phase 3

Not yet recruiting

Brief Summary: Introduction: As per ARDS net study mechanical-ventilation strategies that use lower end-inspiratory (plateau) airway pressures, lower tidal volumes (VT), and higher positive end-expiratory pressures (PEEPs) can improve survival in patients with the acute respiratory distress syndrome (ARDS)1, but the optimal pressures are not known. Transpulmonary pressure guided ventilation may be beneficial in such patients without the drawback of conventional ventilation strategy.

Aim of Study: Our aim is to compare the effect of transpulmonary pressure guided ventilation versus conventional ventilation in patients with A.R.D.S.

Materials & Methods: A randomized prospective cross-over study will be conducted on 100 patients of moderate to severe A.R.D.S. Patients will be randomly allocated into two groups. Group T will receive transpulmonary pressure guided ventilation and Group C will receive conventional ventilation. The patients in each group will cross over to the opposite group after a washout period.

Clinical Significance: This study will help us to find out if transpulmonary pressure guided ventilation improves ventilation parameters

Recruitment & Eligibility

Inclusion Criteria

Patients will be included in the study if they have moderate-to-severe ARDS according to the American-European Consensus Conference definitions.
Duration of ARDS 36 hours or less from meeting final Berlin criterion Age more than 18 years.

Exclusion Criteria

Received mechanical ventilation more than 96â€…h.
Recently treated for bleeding varices, stricture, haematemesis, esophageal trauma, recent esophageal surgery or other contraindication for nasogastric tube placement.
History of lung or liver transplantation.
Severe chronic liver disease (Child-Pugh Score â‰¥12).
Patients not committed to full support.
Inability to get informed consent from the patient or surrogate.
Use of rescue therapies prior to enrolment (including nitric oxide, ECMO, prone positioning) Evidence of active air leak from the lung (including bronchopleural fistula, pneumothorax, pneumomediastinum or air leak from existing chest tube).

Primary Outcome Measures

Name	Time	Method
Improvement in PaO2 /FiO2 ratio	outcomes measured at baseline, at 6 and 12 hours respectively.
Improvement in static compliance	outcomes measured at baseline, at 6 and 12 hours respectively.
VILI like spontaneous pneumothorax	outcomes measured at baseline, at 6 and 12 hours respectively.
Improvement in CO2 exchange	outcomes measured at baseline, at 6 and 12 hours respectively.

Secondary Outcome Measures

Name	Time	Method

Locations (1): dayanand hospital
🇮🇳
Ludhiana, PUNJAB, India
dayanand hospital
🇮🇳Ludhiana, PUNJAB, India
Dr ravi krishna
Principal investigator
917799325566
mravikrishna23@gmail.com