Feasabilty and Physiological Effects of a Ventilation Strategy Combining PEEP and Tidal Volume Titration According to Inspiratory and Expiratory Transpulmonary Pressures in ARDS Patients.
- Conditions
- ARDS, Human
- Interventions
- Other: PEEP and Tidal Volume Titration
- Registration Number
- NCT05337059
- Lead Sponsor
- University Hospital, Angers
- Brief Summary
Expiratory or inspiratory transpulmonary pressures have been proposed to optimize ventilator settings in patients with ARDS. The aim of this study is to assess the feasibility and the physiological effects of a new method based on both expiratory and inspiratory transpulmonary pressures.
- Detailed Description
Expiratory or inspiratory transpulmonary pressures have been proposed to optimize ventilator settings in patients with ARDS. A positive expiratory transpulmonary pressure may be considered as a target to limt the risk of collapse in dependant lung regions. Some authors propose to titrate PEEP to target an inspiratory transpulmonary pressure of 20cmH20 to limit the risk of overdistension in non-dependant regions.The aim of this study is to assess the feasibility and the physiological effects of a new method based on both expiratory and inspiratory transpulmonary pressures.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 25
- Age 18 years or older
- Moderate to severe ARDS
- Written informed consent obtained from patient' surrogates
- Pneumothorax
- Known pregnancy
- Contraindication to electrical impedance tomography or esophageal pressure measurements
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Transpulmonary based ventilation strategy PEEP and Tidal Volume Titration PEEP and tidal volume will be set to target expiratory and inspiratory transpulmonary pressures of 0 and 20 cmH2O, respectively.
- Primary Outcome Measures
Name Time Method Ventilation strategy failure 48 hours Number of patients with failure criteria (barotrauma, hemodynamic failure, rescue therapy or acidemia)
- Secondary Outcome Measures
Name Time Method Short term physiologicals effects on respiratory mechanics 45 minutes distribution of ventilation assed by electrical impedance tomography (COV, %)
All-cause mortality at day 28 28 days All-cause mortality
Ventilator-free days at day 28 28 days Number of alive ventilator free days
Short term physiologicals effects on gas exchange 45 minutes PaCO2 (mmHg)
Short term physiologicals effects on hemodynamics 45 minutes Cardiac index assed by Echocardiography (L/min/m\^2)
Trial Locations
- Locations (1)
Chu Angers
🇫🇷Angers, France