PEEP Titration and Lung Recruitment Potential Assessed by 3D EIT

NCT ID: NCT06594601

Last Updated: 2024-09-19

Basic Information

• Recruitment Status: RECRUITING
• Total Enrollment: 50 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2024-01-01
• Study Completion Date: 2025-12-31

Brief Summary

In a population of ARDS patients, we explore the influence of different PEEP levels on regional ventilation distribution, ventilation homogeneity, and the center of ventilation, optimal PEEP and lung recruitment potential as well as the extent of lung collapse and overdistension as detected by 3D-EIT.

Conditions

ARDS; Respiratory Failure

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

lung recruitment potential assessed by 3D EIT in ARDS

Diagnosis of ARDS was based on the Berlin definition, who have receivied mechanical ventilation. The enrolled patients received a lung recruitment potential assessment by 3D EIT( as the follwoing mentioned )

lung recruitment potential assessed by 3D EIT

Intervention Type: PROCEDURE

Patients were ventilated based on the ARDS-Net suggestions. The patients were kept at supine position. The lung recruitment potential assessed by 3D EIT was as follows:

1. All patients were under pressure control mode (driving pressure 12-15 cmH2O with a tidal volume of 6-8 ml/kg predicted body weight, respiration rate12-15 bpm).

2. PEEP was switched to a zero end-expiratory pressure (ZEEP) for 10 min, and FiO2 was titrated to obtain peripheral oxygen saturation (SpO2 ) > 90%.

3. PEEP was stepwise increase from 0 to 15 cmH2O PEEP in steps of 5cm H2O every 3min.And 3D EIT was used to assess lung recruitment potential.

PEEP titration by 3D EIT for ARDS

Diagnosis of ARDS was based on the Berlin definition, who have receivied mechanical ventilation. The enrolled patients received a lung PEEP tirtation by 3D EIT( as the follwoing mentioned )

PEEP titration by 3D eit

Intervention Type: PROCEDURE

Patients were ventilated based on the ARDS-Net suggestions. The patients were kept at supine position. The PEEP titriatino by 3D EIT fwas as follows:

1. All patients were under pressure control mode (driving pressure 12-15 cmH2O with a tidal volume of 6-8 ml/kg predicted body weight, respiration rate12-15 bpm).

2. RM: PEEP was switched to a 21cmH2O for 2min, and FiO2 was titrated to obtain peripheral oxygen saturation (SpO2 ) ≥90%.

3. PEEP was stepwise decrease from 21 to 0 cmH2O PEEP in steps of 3cm H2O every 2min.

4. 3D EIT was used to monitor regional ventilation distribution during PEEP titration.

Interventions

lung recruitment potential assessed by 3D EIT

Patients were ventilated based on the ARDS-Net suggestions. The patients were kept at supine position. The lung recruitment potential assessed by 3D EIT was as follows:

1. All patients were under pressure control mode (driving pressure 12-15 cmH2O with a tidal volume of 6-8 ml/kg predicted body weight, respiration rate12-15 bpm).

2. PEEP was switched to a zero end-expiratory pressure (ZEEP) for 10 min, and FiO2 was titrated to obtain peripheral oxygen saturation (SpO2 ) > 90%.

3. PEEP was stepwise increase from 0 to 15 cmH2O PEEP in steps of 5cm H2O every 3min.And 3D EIT was used to assess lung recruitment potential.

Intervention Type: PROCEDURE

PEEP titration by 3D eit

Patients were ventilated based on the ARDS-Net suggestions. The patients were kept at supine position. The PEEP titriatino by 3D EIT fwas as follows:

1. All patients were under pressure control mode (driving pressure 12-15 cmH2O with a tidal volume of 6-8 ml/kg predicted body weight, respiration rate12-15 bpm).

2. RM: PEEP was switched to a 21cmH2O for 2min, and FiO2 was titrated to obtain peripheral oxygen saturation (SpO2 ) ≥90%.

3. PEEP was stepwise decrease from 21 to 0 cmH2O PEEP in steps of 3cm H2O every 2min.

4. 3D EIT was used to monitor regional ventilation distribution during PEEP titration.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• patients on mechanical ventilation.
• Diagnosis of ARDS was based on the Berlin definition
• lung recruitment potential assessment and PEEP titration was proper for the ARDS patients determined by the attending doctor

Exclusion Criteria

• Under 18 years of age.
• Pregnant women;
• Ribcage malformation
• Any contraindication to the use of EIT (e.g. automatic implantable cardioverter defibrillator, and implantable pumps).
• Hemodynamic instability, unable to tolerate high PEEP;
• High-risk individuals with pneumothorax, mediastinal emphysema, etc.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Peking Union Medical College Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Huaiwu He, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Critical Care Medicine, Peking Union Medical College, Peking Union Medical College Hospital

Yun Long, PhD

Role: STUDY_DIRECTOR

Department of Critical Care Medicine, Peking Union Medical College, Peking Union Medical College Hospital

Locations

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences,

Beijing, Beijing Municipality, China

Site Status: RECRUITING

Countries

China

Central Contacts

Huaiwu He

Role: CONTACT

tjmuhhw@163.com

15201518815

Facility Contacts

Long Yun, MD

Role: primary

icu_longyun@126.com

Long Yun, MD

Role: backup

Huaiwu He, MM

Role: backup

Other Identifiers

PUMCH

Identifier Type: OTHER

Identifier Source: secondary_id

PEEP by 3D-EIT for ARDS

Identifier Type: -

Identifier Source: org_study_id