Post- End- Expiratory Pressure Affect the Alveolar Heterogeneity in Moderate and Sever ARDS Patients
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- plateau pressure
研究概览
简要总结
This study try to use EIT ( Electronic impedance tomography ) to evaluate the alveolar heterogeneity and use trans-pulmonary pressure and stain to evaluate the lung injury . The study use these methods to figure out how PEEP impact the alveolar heterogeneity and VILI.
详细描述
ARDS(Acute respiratory distress syndrome )is common in patients suffering Sepsis, trauma, burning and other sever condition and characterized by diffuse alveolar damage and alveolar heterogeneity.ARDS patient need MV(mechanical ventilation )to maintain oxygenation and need unique MV tragedy to avoid VILI(Ventilator induced Lung injury ).PEEP(post-end-expiratory pressure) is crucial to maintain oxygenation and avoid VILI according to researches. But there are also some other research different voice. This study try to use EIT ( Electronic impedance tomography ) to evaluate the alveolar heterogeneity and use trans-pulmonary pressure and stain to evaluate the lung injury . The study use these methods to figure out how PEEP impact the alveolar heterogeneity and VILI.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Crossover
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age≥18 or<80；
- •Moderate or sever ARDS in 2012 <Berlin definition>;
- •Applied mechanical ventilation;
- •Consent signed.
排除标准
- •Asthma or COPD；
- •Cardiogenic edema；
- •Sever neutropenia(<500/mm3)；
- •Hemodynamic astatic: DOPA or Dobutamine >15 µg/kg/ min; NE > 15ug /min；
- •GCS coma score ≤12；
- •Thoracic injury or surgery patients contradict EIT ；
- •Refuse to join in trail；
- •Included in other clinical trail。
结局指标
主要结局
plateau pressure
时间窗: September,1,2018-December 30, 2020
The researchers use ventilator to do inspiration pause to measure plateau pressure(cmH2O) in patients with mechanical ventilation and without spontaneous breathing.
Trans-pulmonary pressure
时间窗: September,1,2018-December 30, 2020
The researchers place tube in the esophagus and connect it to transmitter to measure esophageal pressure (mmHg)and calculate trans-pulmonary pressure(mmHg) to evaluate stress
PaO2
时间窗: September,1,2018-December 30, 2020
The researchers use blood gas analysis to measure PaO2( arterial oxygen pressure,mmHg)
PaCO2
时间窗: September,1,2018-December 30, 2020
The researchers use blood gas analysis to measure PaCO2( arterial carbon dioxide pressure,mmHg) .
respiratory rate
时间窗: September,1,2018-December 30, 2020
The researchers record the set respiratory rate(bpm) in patients with mechanical ventilation.
peak pressure
时间窗: September,1,2018-December 30, 2020
The researchers use ventilator to measure peak pressure(cmH2O) in patients with mechanical ventilation and without spontaneous breathing..
flow
时间窗: September,1,2018-December 30, 2020
The researchers record the set Flow (L/min) in patients with mechanical ventilation.
alveolar hyper-distention; alveolar collapse；alveolar opening and closing；
时间窗: September,1,2018-December 30, 2020
The study use Pulmo Vista 500 device (Drager co.),is intended to perform thoracic bioimpedance measurements by applying the technique of electrical impedance tomography (EIT)to evaluate alveolar hyper-distention(%of the lung volume); alveolar collapse(% of the lung volume)；alveolar opening and closing(% of the lung volume).
EELV
时间窗: September,1,2018-December 30, 2020
The research use nitrogen wash out to measure EELV（end-expiratory lung volume, ml） to calculate dynamic strain and evaluate the strain
tidal volume
时间窗: September,1,2018-December 30, 2020
The researchers use ventilator to measure tidal volume(ml) in patients with mechanical ventilation and without spontaneous breathing..
FiO2
时间窗: September,1,2018-December 30, 2020
The researchers record the set FiO2 ( fraction of inspiratory oxygen, %) in patients with mechanical ventilation.
次要结局
- DBP(September,1,2018-December 30, 2020)
- CVP(September,1,2018-December 30, 2020)
- SBP(September,1,2018-December 30, 2020)
- vasopressor(September,1,2018-December 30, 2020)
研究者
Ling Liu
Director
Southeast University, China