Ignite Creation Date:
2024-05-06 @ 7:55 PM
Last Modification Date:
2024-10-26 @ 3:16 PM
Study NCT ID:
NCT06181539
Status:
RECRUITING
Last Update Posted:
2023-12-26
First Post:
2023-12-13
Brief Title:
Evaluate the Effect of Prone Ventilation on Ventilated-blood Flow Ratio in Patients With ARDS by EIT
Sponsor:
Wuhan Union Hospital China
Organization:
Wuhan Union Hospital China
Study Overview
Official Title:
Evaluate the Effect of Prone Ventilation on Ventilated-blood Flow Ratio in Patients With Acute Respiratory Distress Syndrome by Electrical Impedance Tomography
Status:
RECRUITING
Status Verified Date:
2023-01
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Patients with ARDS often suffer a gravity-dependent alveolar collapse resulting in a reduction of tidal volume residual alveolar excessive distension and ventilator-related lung injuryVILI induced by unreasonable ventilator settingProne ventilation PPV improves the gravity-dependent alveolar ventilation and promotes lung recruitment in the gravity-dependent area and improves lung compliance Previous studies showed that prolonged PPV combined with low tidal volumeLTV lung protected ventilation can significantly reduce the mortality of patients with moderate to severe ARDSAlthough more than 60 of patients with moderate to severe ARDS due to COVID-19 has been widely implemented PPVstudies showed an improvement in oxygenation in patients with ARDSthe PF radio improved by more than 20 before and after PPV was 9-77 that is That is some patients are unresponsive to PPV In addition some patients showed CO2 responsiveness after PPVventilation rate VR decreased significantly after PPVThe tools for monitoring the effects of PPV on ventilation and blood flow at bedside are still lacking Electrical impedance tomography EIT is a non-invasive non-radiative real-time bedside lung imaging technique that can monitor local lung ventilation distribution This study intends to use EIT to evaluate pulmonary ventilation blood flow distribution and local VQ ratio before and after PPV as well as to monitor the changes in pulmonary physiology before and after PPV explore the mechanism of PPV improving oxygenation by combined with the changes in oxygenation and explore the factors that predict and affect PPV responsiveness
Detailed Description:
Acute respiratory distress syndrome ARDS is presented as acute hypoxemia and pulmonary edema due to the increased permeability of alveolar capillaries Endothelial damage injury and swelling microthrombosis and hypoxic pulmonary vasoconstriction can lead to low pulmonary blood vessels perfusion and even occlusion while patients with ARDS often suffer a gravity-dependent alveolar collapse resulting in a reduction of tidal volume residual alveolar excessive distension and ventilator-related lung injuryVILI induced by unreasonable ventilator settingProne ventilation PPV improves the gravity-dependent alveolar ventilation and promotes lung recruitment in the gravity-dependent area and improves lung compliance Besides pulmonary blood perfusion is less affected by gravity distribution thus the improvement of gravity-dependent alveolar ventilation can significantly reduce shunt and lung heterogeneity and improve VQ radio Previous studies showed that prolonged PPV combined with low tidal volume lung protected ventilation can significantly reduce the mortality of patients with moderate to severe ARDSAlthough more than 60 of patients with moderate to severe ARDS due to COVID-19 has been widely implemented PPVstudies showed an improvement in oxygenation in patients with ARDSthe PF radio improved by more than 20 before and after PPV was 9-77 that is That is some patients are unresponsive to PPV In addition some patients showed CO2 responsiveness after PPV ventilation rate VR decreased significantly after PPVThe tools for monitoring the effects of PPV on ventilation and blood flow at bedside are still lacking Electrical impedance tomography EIT is a non-invasive non-radiative real-time bedside lung imaging technique that can monitor local lung ventilation distribution By injecting hypertonic saline through a central vein catheter we can obtain lung perfusion images to indicate local lung blood flow distribution In addition combined with lung ventilation images we can evaluate the pulmonary shunt dead space VQ ratio to better clarify the physiological and pathological status of lungThis study intends to use EIT to evaluate pulmonary ventilation blood flow distribution and local VQ ratio before and after PPV as well as to monitor the changes in pulmonary physiology before and after PPV explore the mechanism of PPV improving oxygenation by combined with the changes in oxygenation and explore the factors that predict and affect PPV responsiveness
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None