Impact of Belt Position on the Results of PEEP Titration by EIT During ARDS

Not Applicable

Not yet recruiting

• Conditions: ARDS
• Interventions: Device: EIT

• Registration Number: NCT06541522
• Lead Sponsor: Centre Hospitalier Saint Joseph Saint Luc de Lyon

Brief Summary

ARDS is a frequent reason for hospitalization in intensive care. In order to improve its management, doctors seek to limit the mechanical ventilation-induced injuries (VILI) that can occur. PEEP is a parameter that plays a role in the appearance of VILI, and its adjustment can be optimized by EIT. The EIT is a non-invasive, non-irradiating, real-time monitoring device, today widely used for the optimization of ventilation in patients intubated for ARDS. The positioning of the EIT belt at different chest heights could influence the result of the PEEP titration.

Detailed Description

The aim of this study is to test the hypothesis that the position (2nd intercostal space or 5th intercostal space) of the EIT (Electrical Impedance Tomography) belt significantly influences the result of PEEP (Positive Expiratory Pressure) titration.

Study Timeline

• Study First Submitted: 2024-07-30
• Study First Submitted QC: 2024-08-02
• Study First Posted: 2024-08-07
• Status Verified: 2024-11
• Last Update Submitted: 2024-11-19
• Last Update Posted: 2024-11-21
• Study Start: 2025-01-01
• Primary Completion: 2026-01
• Study Completion: 2026-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• Occurrence of moderate to severe ARDS (PaO2/FiO2 ratio ≤ 200 mmHg) within 72 hours following intubation
• Criteria for moderate to severe ARDS for less than 72 hours
• Passive ventilation in controlled assisted ventilation (no spontaneous ventilation)
• Consent of next of kin

Exclusion Criteria

• Age < 18 years
• ECMO
• Pneumothorax
• Pacemaker or implantable defibrillator
• Chest trauma in the last 3 months
• Skin peeling (Burned, Lyell)
• Intracranial hypertension
• Uncontrolled shock (noradrenaline >5 mg/h)
• Pregnant woman
• Adult patient protected within the meaning of the law
• Lack of social security

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
PEEP titrations	EIT	-

Primary Outcome Measures

Name	Time	Method
Impact of the position of the electrode belt on the results of PEEP titration by EIT.	Day 0	Optimal PEEP determined by PEEP titration using the crossing point method.

Secondary Outcome Measures

Name	Time	Method
Factors associated with a discordance between PEPEIT and PEPCRS	Day 0	Variability of the impedance variation during insufflation of the tidal volume ("tidal impedance variation) during titration measured by the relative interquartile coefficient (Q3-Q1)/median
Impact of the existence of intra-tidal recruitment on the discordance between PEPEIT and PEPCRS	Day 0	Variability of the impedance variation during insufflation of the tidal volume ("tidal impedance variation) during titration measured by the relative interquartile coefficient (Q3-Q1)/median
Discrepancy between compliance measured according to impedance and compliance measured according to exhaled volume	Day 0	Regional ventilation delay (RVD)