Quantitative Computed Tomography for Mortality Risk Stratification in ARDS

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

210 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-11-06

Study Completion Date

2025-05-01

Brief Summary

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Acute respiratory distress syndrome remains a deadly disease with hospital mortality remaining between 40 to 50%. ARDS mortality risk factors have been identified from patient history, common clinical and biological variables in the lung SAFE study. Part of ARDS mortality is attributable to ventilator-induced lung injury (VILI), in relation with inappropriate settings on the ventilator. Tidal hyperinflation and recruitment/derecruitment during lung inflation are 2 identified mechanisms leading to VILI, that may be identified on computed tomography while poorly identified with variables collected at the bedside.

The aim of this study is to identify whether tidal hyperinflation identified on computed tomography is a risk factor for ARDS mortality, independently from know bio-clinical risk factors.

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Detailed Description

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Conditions

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Acute Respiratory Distress Syndrome

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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tidal hyperinflation

As the study aim to identify whether tidal hyperinflation is an independent predictor for ARDS mortality, and as this variable will be entered as a quantitative predictor in the multivariate model, the study encompass a single group of patient (i.e. all included patients)

Low dose computed tomography to evaluate biomechanical parameters in the lung

Intervention Type RADIATION

In the participating to the study, response to PEEP increase and tidal inflation are evaluated with a software computing biomechanical parameters (tidal hyperinflation and lung recruitability). Tidal hyperinflation and recruitment are computed on CT images acquired within 72 hours after ARDS onset or with 72h after ECMO onset.

Interventions

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Low dose computed tomography to evaluate biomechanical parameters in the lung

In the participating to the study, response to PEEP increase and tidal inflation are evaluated with a software computing biomechanical parameters (tidal hyperinflation and lung recruitability). Tidal hyperinflation and recruitment are computed on CT images acquired within 72 hours after ARDS onset or with 72h after ECMO onset.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Patient aged 15 or older with ARDS according to the Berlin definition
* invasive mechanical ventilation with PaO2/FiO2 ≤ 300 mm Hg
* with computed tomography acquired at both end-expiration and end-inspiration, or at both PEEP 5 and 15 cm H2O at end-expiration
* PEEP setting according to a PEEP/FiO2 table, with secondary adjustment according to hemodynamic tolerance
* Tidal volume 6 ml/kg of predicted body weight or less

Exclusion Criteria

* Use of contrast agent during computed tomography acquisition
* ARDS criteria onset since more than 72 hours or ECMO onset since more than 72 hours
* Proven COPD
* Pneumothorax or bronchopleural fistula
* Patient with spontaneous breathing preventing realization of end-expiratory and end-inspiratory pauses
* Previous inclusion in current study
* Patient under a legal protective measure

Minimum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No