Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
COMPLETED
32 participants
OBSERVATIONAL
2019-12-13
2021-05-31
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Admitted ventilated patients who are greater than 18 years old and fulfilled the Berlin's diagnostic criteria of moderate to severe ARDS will be selected to enter our study. The exclusion criteria include (1) patients with metallic materials in the body (including wire, pin or implanted electrical devices etc.); (2) patients with cutaneous diseases which prohibited the application of electrode leads to attached the body; (3) severe chronic obstructive pulmonary diseases; (4) hemodynamically unstable; (5) proved barotrauma (including pneumothorax or pneumomediastinum etc.); (6) pregnancy; (7) diseases characterized with increased intracranial pressure; (8) patients or family who refused the informed consent. All patients who fulfilled the diagnosis of ARDS will receive standard care of low tidal volume ventilator therapy. The tidal volume 6 ml/Kg will be used. The investigators expect to enroll at least 20 analyzable cases. Sedation and paralysis are usually used in moderate to severe ARDS patients and daily interruption of sedation and paralysis is a standard practice. The investigators will perform recording during daily interruption of sedation and paralysis, up to 60 minutes period will be recorded during the interruption period. Recording will be done at least once for registered case and could be repeated in case of unsatisfactory signals.
Instrumentation In all patients, air flow will be measured using a pneumotachograph (Hamilton AG, or Hans Rudolf) connected to a differential pressure transducer (MP 45, Validyne Corp., Northridge, CA). The flow sensor will be placed between the endotracheal tube and the Y-piece of the ventilator. Tidal volume will be obtained by integrating the flow signal. Airway pressure and esophageal pressure will be measured using differential pressure transducers (P300D, Validyne Corp., Northridge, CA.). An appropriate esophageal pressure signal will be confirmed according to the standard guideline\[27\]. All signals are sampled and digitalized at 200 Hz and data are stored in a data acquisition system (MP150, Acqknowledgement, Biopac, Goleta, CA).
Measurements:
Electrical impedance tomography:
The investigators use a commercial EIT monitor (PulmoVista 500, Drager Medical GmbH, Lubeck, Germany). An electrode belt with 16 equally spaced electrodes will be placed around the patient's thorax at the 4th to 5th intercostal space. Impedance data will be acquired by applying adjacent alternate current injection (50 KHz) and measuring the voltage difference between the adjacent leads and a finite element method-based, linearized Newton-Raphson reconstruction algorithm is used to construct the impedance data. The PulmoVista 500 monitor displays functional EIT images, i.e. relative impedance changes including tidal ventilation and end-expiratory lung impedance (EELI) changes. During the study phases, EIT data will be registered at 20-40 Hz and low-pass filtered (35 per minute) and stored for offline analysis.
The individual impedance recording (10 minutes per segment) will be linked into a single file and impedance calculation will thus be done off-line. The investigators will subdivide the impedance recordings into ventral to dorsal parts. The investigators define the presence of pendelluft as the presence of opposite impedance change (△Z) between dependent and independent zones during a breathing effort. The breath could occur in inspiration phase, expiratory phase or in transition. Estimation of volume of pendelluft will be determined by the integrated volume and corresponding impedance change.
Respiratory mechanics:
The investigators will record the peak and plateau airway pressure, total PEEP, flow and the esophageal pressure. Transpulmonary pressure (PL) will be calculated as the difference between Paw and Pes calculate the transpulmonary pressure.
Study protocol The investigators target at moderate to severe ARDS patients who are already under deep sedation with neuromuscular blockade. As daily interruption of sedatives and muscle relaxant are routinely performed in our ICU, we will record the respiratory mechanics and EIT data for about one hour which should include both controlled and spontaneous breathing period.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Keywords
Explore important study keywords that can help with search, categorization, and topic discovery.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
CASE_ONLY
PROSPECTIVE
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
Exclusion Criteria
* Proved barotrauma (including pneumothorax or pneumomediastinum etc.);
* Pregnancy
* Diseases characterized with increased intracranial pressure
* Patients or family who refused the informed consent.
18 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
National Cheng-Kung University Hospital
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Chang-Wen Chen
Associate professor and attending physician
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Chang-Wen Chen, MD
Role: PRINCIPAL_INVESTIGATOR
National Cheng-Kung University Hospital
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Chang-Wen Chen
Tainan City, , Taiwan
Countries
Review the countries where the study has at least one active or historical site.
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
EIT and ARF
Identifier Type: -
Identifier Source: org_study_id