Evaluation of POC Lung Ultrasound Combined With Pressure-volume Curve to Titration Adjust PEEP for ARDS Lung Recruitment

Not Applicable

• Conditions: Acute Respiratory Distress Syndrome
• Interventions: Device: Lung Ultrasound; Diagnostic Test: Maximum Oxygenation

• Registration Number: NCT03076450
• Lead Sponsor: Shanghai Pudong New Area Gongli Hospital

Brief Summary

Using lung ultrasound re-aeration score(LUS-RAS) combined with pressure-volume curve(PVC) adjust maintain positive end-expiratory pressure(PEEP) after recruitment maneuver, to achieve real-time adjustment, reduce ventilation-associated lung injury and the purpose of effective lung recruitment.

Detailed Description

The traditional method, set PEEP according to PVC in ARDS mechanical ventilation, lacks morphological evaluation. For point-of-care lung ultrasound(POC-LUS) is non-invasive, real-time, visualization, no need transport patients, getting more and more attention in the ARDS treatment. It has been reported that LUS-RAS is a meaningful assessment in recruitment maneuver. This study will combine POC-LUS with PVC in set the initial peep, and then dynamic record LUS-RAS to feedback regulate PEEP. Using the POC-LUS and maximum oxygenation method to assess lung recruitment effect in experimental group and control group prospectively. The ventilator parameters, state of hemodynamic, arterial blood gas(ABG) in each group will be recorded; Statistical methods will be performed in term to understand the correlation.

Study Timeline

• Study Start: 2017-03-01
• Study First Submitted: 2017-03-07
• Study First Submitted QC: 2017-03-09
• Study First Posted: 2017-03-10
• Status Verified: 2017-04
• Last Update Submitted: 2017-04-29
• Last Update Posted: 2017-05-02
• Primary Completion: 2018-03-01
• Study Completion: 2018-09-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• patient aged 18 years and older
• ARDS patients with invasive mechanical ventilation

Exclusion Criteria

• Intracranial hypertension
• Pneumothorax and mediastinal emphysema
• Severe hypoxemia (oxygenation index <100)
• Hemodynamic instability
• Chest deformity or surgical history
• Affect Lung-ultrasound conditions: subcutaneous emphysema, chest wound etc.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Lung Ultrasound Re-aeration Score	Lung Ultrasound	Combine POC-LUS with PVC in set the initial peep, and then dynamic record LUS-RAS to feedback regulate PEEP.
Maximum Oxygenation	Maximum Oxygenation	Using PVC to set the initial peep, check ABG real-time, and according to PaO2+PaCO2≥400mmHg whether or not to adjust maintain PEEP.

Primary Outcome Measures

Name	Time	Method
Lung Ultrasound re-aeration score, LUS-RAS	48 hours	The score is composed of 12 different regions of chest wall checked by POC-LUS.

Trial Locations

Locations (1)

Gongli Hospital; 🇨🇳 Pudong, Shanghai, China