A Comparison of Optimal PEEP Determination Guided by EIT and Conventional Protective Ventilation Tool in ARDS Patients
- Conditions
- ARDSAcute Respiratory Distress Syndrome
- Interventions
- Device: Electrical Impedance TomographyDevice: Ventiltor P/V Loop
- Registration Number
- NCT03498807
- Lead Sponsor
- Hui-Ju Hsu
- Brief Summary
The study of positive end-expiratory pressure(PEEP) in the setting mode has not yet been conclusive. there are several ways to choose the best positive end-expiratory pressure(PEEP) mode for ARDS patients. In this study ,the investigators selected two best positive end-expiratory pressure(PEEP) assessment methods to compare:
First is using the conventional postive ventilator to choose positive end-expiratory pressure(PEEP) and the new non-invasive electrical impedance tomography(EIT) guided method and evaluation the treatment outcome in moderate and severe acute respiratory distress syndrome patients by using pressure-volume curve guided and electrical impedance tomography guided positive end-expiratory pressure setting. In this project, we utilize a newly available non-invasive method- electric impedance tomography (EIT) and Protective Ventilation to determine the optimal PEEP on ARDS patients required invasive mechanical ventilator support at a medical center medical ICU (MICU) and cardiovascular ICU (CVICU)- the Far Eastern memorial hospital, Taiwan.
- Detailed Description
Acute respiratory distress syndrome (ARDS)，over the years in the treatment policy has been confirmed that: with low tidal volume to achieve lung protection strategy and high positive end-expiratory pressure (PEEP), both can effectively reduce the mortality rate. And increase PEEP，the alveolar pressure is greater than the atmospheric pressure when exhaled，So that can be effective expansion of the lungs to avoid spitting at the end of the alveolar collapse.
The study of PEEP in the setting mode has not yet been conclusive. Currently in the clinical situation，there are several ways to choose the best PEEP mode for ARDS patients. In this study the investigators selected two best PEEP assessment methods to compare:
First is using the conventional postive ventilator to choose optimal and the new non-invasive electrical impedance tomography guided method and evaluation the treatment outcome in moderate and severe acute respiratory distress syndrome patients by using pressure-volume curve guided and electrical impedance tomography guided positive end-expiratory pressure setting. In this project, the investigators utilize a newly available non-invasive method- electric impedance tomography (EIT) and Protective Ventilation to determine the optimal PEEP on ARDS patients required invasive mechanical ventilator support in ICU at the Far Eastern memorial hospital, Taiwan.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 87
- Moderate to severe ARDS patient on mechanical ventilation from ER or word transfer ICU. (P/F≦ 200 with PEEP ≥ 5cmH20) (PEEP greater than or equal to 5 cm H2O and Berlin criteria for ARDS)
- On pacemaker
- Pregnant
- Thoracic or spinal cord trauma
- Pneumothorax
- Hemodynamic instability
- IICP
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Study group_Use EIT Electrical Impedance Tomography Use the Electrical Impedance Tomography Control group_Use Ventilator P/V tool Ventiltor P/V Loop Use the Pressure/Volume Loop
- Primary Outcome Measures
Name Time Method Compare the survival rate between two groups Compare the survival rate between two groups during 91 days in hospitalization Calculate the survival rate
- Secondary Outcome Measures
Name Time Method Oxygention improve rate in the hospital Compare the PaO2/FiO2 ratio after fixed Optimal PEEP 48hrs later Calculate PaO2/FiO2 ratio improvement rate in the hospital
Trial Locations
- Locations (1)
Far Eastern Memorial Hospital
🇨🇳Taipei county, Banqiao Dist, Taiwan