Cardiopulmonary Effects of Prone Position in CARDS
- Conditions
- ARDS Due to Disease Caused by SARS Co-V-2Right Ventricular Dysfunction
- Registration Number
- NCT06456606
- Lead Sponsor
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital
- Brief Summary
In coronavirus disease-2019 (COVID-19)-related ARDS (C-ARDS), especially in the severe form, increased shunt rate, impaired ventilation/perfusion ratio (V/Q), hypoxic pulmonary vasoconstriction inhibition, and increased immune microthrombosis may have similar effects on the right ventricle .The cardiopulmonary pathophysiology and outcomes of C-ARDS vary, and this variability requires monitoring to follow the diagnosis and treatment process. This study aimed to increase the treatment success of the prone position in C-ARDS and to provide a prognostic factor for survival by analyzing and monitoring heart-lung interactions. Therefore, we used transesophageal echocardiography (TEE) to evaluate the cardiopulmonary effects of prone position.
- Detailed Description
This prospective study included 30 moderate-to-severe C-ARDS patients who were treated with prone position in the first 48 hours of invasive mechanical ventilation support. It was evaluated with transesophageal echocardiography three times: before prone position (PP) (T0), the first hour of PP (T1), and the first hour of returning to the supine position (T0 + 24 hours) (T2) after 23 hours prone position treatment. Right ventricular end-diastolic area/left ventricular end-diastolic area (RVEDA/LVEDA) was preferred right ventricular evaluations as primer outcome. Static compliance (C-stat) was examined in the evaluation of the pulmonary effect of prone position as secondary outcome.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 30
- >18 years
- Patients diagnosed with polymerase chain reaction/computed tomography results
- Moderate/severe severity class according to the Berlin ARDS classification
- Prone position applied in the first 48 h after orotracheal intubation in treatment
- Obtaining an informed consent form
- Pulmonary embolism
- Pneumothorax
- Heart valve disease
- Pregnancy
- Perforated esophageal varices
- Coagulopathy
- Esophageal stricture
- Esophageal tumor
- Neck fracture
- Thrombocytopenia
- Gastrointestinal bleeding
- Previous stomach surgery
- Previous esophageal surgery
- Esophageal perforation
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Right ventricular end-diastolic area/left ventricular end-diastolic area (RVEDA/LVEDA) change during prone position. It was evaluated with transesophageal echocardiography three times: before prone position (T0), the first hour of prone position (T1), and the first hour of returning to the supine position (T0 + 24 hours) (T2) after 23 hours prone position treatment It was preferred right ventricular recovery evaluation.
- Secondary Outcome Measures
Name Time Method Static compliance (C-stat) change with prone position It was evaluated with transesophageal echocardiography three times: before prone position (T0), the first hour of prone position (T1), and the first hour of returning to the supine position (T0 + 24 hours) (T2) after 23 hours prone position treatment It was examined in the evaluation of the pulmonary effect of prone position as secondary outcome.
Related Research Topics
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Trial Locations
- Locations (1)
Bakirkoy Dr. Sadi Konuk Research Hospital
🇹🇷Istanbul, Bakırköy, Turkey
Bakirkoy Dr. Sadi Konuk Research Hospital🇹🇷Istanbul, Bakırköy, Turkey