Pulmonary Overdistension Assessment With Electrical Impedance Tomography in Patients With Acute Respiratory Distress Syndrom in Prone Position
Overview
- Phase
- Not Applicable
- Intervention
- Acute Respiratory Distress Syndrom (ARDS) treated with Prone Position (PP) equipped with Electrical Impedance Tomography (EIT)
- Conditions
- Acute Respiratory Distress Syndrome
- Sponsor
- University Hospital, Bordeaux
- Enrollment
- 20
- Locations
- 2
- Primary Endpoint
- Level of distension
- Status
- Recruiting
- Last Updated
- 3 months ago
Overview
Brief Summary
Mechanical ventilation in ARDS requires protective ventilation with low VT and PEEP. PEEP titration can improve lung recruitment in the dependent lung but with a risk of overdistension in the non-dependant lung. EIT can measure the distribution of tidal ventilation and assess overdistension and collapse during a PEEP titration in any position (prone or not).
This study aims to measure the best PEEP as a compromise between recruitment and overdistension during a PEEP trial with EIT before and just after PP.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients hospitalized in the ICU and who suffered moderate or severe ARDS (Berlin criteria, PaO2/FiO2\<150), intubated sedated, under myorelaxant and equipped with EIT
- •Over the age of 18.
Exclusion Criteria
- •Broncho-pleural leaks
- •Pregnant or breastfeeding woman.
- •Guardianship or curatorship
- •Deprived of liberty
- •No health insurance
- •Impossibility to correctly position the EIT belt (e.g., dressings, chest drainage, etc.)
- •Contra indications to EIT (e.g., implantable cardiac defibrillator, pacemaker, instable spinal lesions)
Arms & Interventions
Study group
Patients with moderate or severe ARDS treated with PP equipped with EIT will be included. Measurement of EIT data and ventilator spirometry in supine position and just after turning the patient in PP during a decremental PEEP-EIT titration, will be done, and blood gases and finally haemodynamic data
Intervention: Acute Respiratory Distress Syndrom (ARDS) treated with Prone Position (PP) equipped with Electrical Impedance Tomography (EIT)
Outcomes
Primary Outcomes
Level of distension
Time Frame: 48 hours after inclusion day
Assessing the level of distension when titrating the optimal PEEP in the supine position (SP) and in the PP position the first and second day of ARDS in PP. The measure will be obtained thanks to the crossing in EIT of the overdistension curve and the collapse curve when the PEEP is reduced from 20 to 5 cmH2O.
Secondary Outcomes
- Repartition of regional ventilation in each part of the lungs.(48 hours after inclusion day)
- Comparison of the percent of overdistension and collapse during the EIT-PEEP titration(48 hours after inclusion day)