Characterization of the microVAScular Dysfunction in COvid-19 ARDS
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- ARDS, Human
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Prognostic value of alveolar dead space
- Last Updated
- 4 years ago
Overview
Brief Summary
The primary endpoint of this research is to establish that the alveolar dead space is significantly higher in patients with COVID-19 ARDS, compared to patients with non-COVID-19 ARDS.
Secondarily, the investigators want to establish the prognostic value of the alveolar-dead space (measured iteratively) in patients with COVID-19 and non-COVID-19 ARDS, to establish the respective influences of the biological parameters of endothelial damage, of the biological parameters of coagulopathy, of the parameters set on the artificial ventilator on the value of the alveolar dead space; in ARDS patients with COVID-19 and non-COVID-19 ARDS, to establish the prognostic value of the laboratory parameters of endothelial damage and coagulopathy in patients with COVID-19 and non-COVID-19 ARDS.
Detailed Description
Endothelial damage and coagulation activation at the lung microvascular level may play an important role in the physiopathology of the COVID-19 ARDS. The project aims to prospectively investigate both bedside pulmonary physiological markers and biological markers of coagulopathy and endothelial dysfunction in COVID-19 and non-COVID-19 ARDS patients.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age\> 18 years old
- •Invasive mechanical ventilation in place for less than 48 hours
- •Severe or moderate ARDS (defined according to the Berlin classification)
- •Virological confirmation by PCR of SARS-CoV-2 infection (ARDS COVID-19)
- •Lack of virological confirmation by PCR of SARS-CoV-2 infection (ARDS not linked to COVID-19)
- •Patient information
Exclusion Criteria
- •Massive pulmonary embolism
- •Chronic respiratory failure under long-term oxygen therapy
- •Dying patient
Outcomes
Primary Outcomes
Prognostic value of alveolar dead space
Time Frame: Up to 28 days
Recording the exhaled CO2 curve (side-stream capnography method) and volume curve, as determined by the mechanical ventilator, and computing the signals with the arterial CO2 partial pressure, reflecting the partial pressure of CO2 in the alveoli participating in gas exchanges), determined on arterial blood gas (ABG) sampling.
Secondary Outcomes
- Level of circulating endothelial cells(Up to 28 days)
- Prognostic value of the alveolar dead space (measured iteratively)(28 days)
- Level of endothelial proteomics(Up to 28 days)
- Level of Willebrand Factor(Up to 28 days)
- Level of fragments of plasminogen(Up to 28 days)
- Level of the components of the NETs (Neutrophil Extracellular Traps)(Up to 28 days)
- Level of progenitor cells(Up to 28 days)
- Level of circulating stem cells(Up to 28 days)
- Level of D-dimers(Up to 28 days)
- Level of components of the fibrinolytic system(Up to 28 days)
- Survival rate(90 days)