Effect of Transpulmonary Mechanical Power on the Prognosis of Patients With Severe Acute Respiratory Distress Syndrome Treated With Venovenous Extracorporeal Membrane Oxygenation
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Respiratory Distress Syndrome
- Sponsor
- Beijing Chao Yang Hospital
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Patients successfully weaned from VV-ECMO
- Status
- Recruiting
- Last Updated
- 10 months ago
Overview
Brief Summary
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a salvage treatment for severe acute respiratory distress syndrome (ARDS). With the large-scale implementation of VV-ECMO in critical care medicine departments in China, significant progress has been made in treating severe ARDS. However, the patient mortality rate remains high. The pathophysiological essence of ARDS is an imbalance between the body's oxygen supply and demand, causing tissue and cell hypoxia, organ dysfunction, and even death. The VV-ECMO treatment process still requires mechanical ventilation assistance. However, inappropriate mechanical ventilation settings can lead to ventilator-related lung injury (VILI). In recent years, mechanical power has gradually attracted everyone's attention and is considered the cause of VILI. The transpulmonary mechanical power is more accurate to the energy directly performed to the lung tissue. Transpulmonary mechanical energy has a specific value in judging the prognosis of mechanically ventilated patients, but its clinical significance in treating patients with VV-ECMO is unclear. This study aimed to explore the value of transpulmonary mechanical power in predicting the prognosis of patients with severe ARDS patients treated with VV-ECMO.
Investigators
Rui Wang
Principal Investigator
Beijing Chao Yang Hospital
Eligibility Criteria
Inclusion Criteria
- •Meet the diagnostic criteria of Berlin's definition for ARDS;
- •Receiving VV-ECMO support.
Exclusion Criteria
- •Patients had been on high pressure (Ppeak \>35 cm H2O) and a high fraction of inspired oxygen (FiO2\>0.8) ventilation for \>7 days;
- •Patients had a contraindication to heparinization;
- •Patients had an irreversible neurological injury;
- •Patients had severe chronic lung disease with life expectancy \<6 months.
Outcomes
Primary Outcomes
Patients successfully weaned from VV-ECMO
Time Frame: After patients enrolled 60 days
Weaning VV-ECMO more than 48 hours with stable oxygenation and no need to re-establish ECMO
Secondary Outcomes
- 60-day mortality(After patients enrolled 60 days)