Feasabilty and Physiological Effects of a Ventilation Strategy Combining PEEP and Tidal Volume Titration According to Inspiratory and Expiratory Transpulmonary Pressures in ARDS Patients..
概览
- 阶段
- 不适用
- 干预措施
- PEEP and Tidal Volume Titration
- 疾病 / 适应症
- ARDS, Human
- 发起方
- University Hospital, Angers
- 入组人数
- 9
- 试验地点
- 1
- 主要终点
- Ventilation strategy failure
- 状态
- 已完成
- 最后更新
- 18天前
概览
简要总结
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.
详细描述
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.
研究者
入排标准
入选标准
- •Age 18 years or older
- •Moderate to severe ARDS
- •Written informed consent obtained from patient' surrogates
排除标准
- •Pneumothorax
- •Known pregnancy
- •Contraindication to electrical impedance tomography or esophageal pressure measurements
研究组 & 干预措施
Transpulmonary based ventilation strategy
PEEP and tidal volume will be set to target expiratory and inspiratory transpulmonary pressures of 0 and 20 cmH2O, respectively.
干预措施: PEEP and Tidal Volume Titration
结局指标
主要结局
Ventilation strategy failure
时间窗: 48 hours
Number of patients with failure criteria (barotrauma, hemodynamic failure, rescue therapy or acidemia)
次要结局
- All-cause mortality at day 28(28 days)
- Ventilator-free days at day 28(28 days)
- Short term physiologicals effects on hemodynamics(45 minutes)
- Short term physiologicals effects on respiratory mechanics(45 minutes)
- Short term physiologicals effects on gas exchange(45 minutes)