An observational study in Acute Respiratory Failure, ARDS and Electrical Impedance Tomography, sponsored by Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone Palermo. Status unknown at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-03-27.
Sponsored by Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone Palermo · Observational
The aim of this study is to describe the effects of different levels of pressure support on ventilation-perfusion matching in patients recovering from ARDS, using electrical impedance tomography.
Spontaneous breathing during mechanical ventilation has been attributed to both protective and negative effects on patient outcomes, largely varying based on the severity of lung injury. Indeed, in severe ARDS the avoidance of spontaneous efforts has an established protective role. However, spontaneous breathing promotes the distribution of tidal volume towards the dependent lung, and low levels of support pressure determine more homogeneous ventilation in patients recovering from ARDS, compared to higher support levels. Physiology supports the potential of spontaneous breathing to increase lung perfusion, through the decrease of intra-thoracic pressure leading to an increased venous return. This mechanism, in absence of right ventricular dysfunction, may lead to increased global lung perfusion. Furthermore, gas exchange improvements in experimental lung injury models during pressure support vs. controlled ventilation have been explained with redistribution of lung perfusion to nondependent lung areas and improvement of V/Q matching even in absence of significant lung recruitment.
Electrical impedance tomography has been clinically used as a non-invasive tool to assess V/Q matching in patients with ARDS and to compare V/Q matching prior to and after a cycle of prone position in spontaneously breathing patients with COVID-19.
The aim of this study is to describe the effects of different levels of pressure support on ventilation-perfusion matching in patients recovering from ARDS, using electrical impedance tomography.
1,650 studies on the registry are indexed under Respiratory Insufficiency; 296 are open to participants now.
This study's planned enrollment of 15 is below the median of 100 across 545 observational studies indexed under Respiratory Insufficiency.
Browse Respiratory Insufficiency studies →Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone Palermo is the lead sponsor of 17 studies on the registry; 3 are open to participants now.
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Adult patients who were admitted to ICU with acute respiratory distress syndrome (ARDS) or developing it during ICU stay.
Exclusion Criteria:
Adult mechanically ventilated patients with ARDS (see inclusion/exclusion criteria)
Other: Level of pressure support
Patients will be evaluated in two different conditions sequentially. The first condition will be at a clinically selected level of pressure support under stable clinical conditions. This condition will be labeled according to P0.1: * In case of P0.1\<2, the clinically selected level of pressure support will be considered "High Pressure support". * In case of P0.1\>2, the clinically selected level of pressure support will be considered "Low Pressure support". After data collection at clinically selected level of pressure support, pressure support level will be transiently increased or decreased (i.e. from high to low/ from low to high) to the lowest/highest clinically tolerated level, aiming at the predefined P01 thresholds, and then kept for 20 minutes under stable clinical conditions. Data collection will be repeated and then the clinically selected level of pressure support restored.
Changes in ventilation-perfusion matching
Changes in ventilation-perfusion matching between the two different levels of pressure support ("high" level of pressure support and "low" level of pressure support)
Time frame: Measured after at least 20 minutes from the application of each of the levels of pressure support and at clinical stability
Changes in gas exchange
Changes in gas exchange measured by blood gas analysis between the two different levels of pressure support ("high" level of pressure support and "low" level of pressure support)
Time frame: Measured after at least 20 minutes from the application of each of the levels of pressure support and at clinical stability
Changes in regional ventilation distribution
Changes in regional ventilation distribution between the two different levels of pressure support ("high" level of pressure support and "low" level of pressure support)
Time frame: Measured after at least 20 minutes from the application of each of the levels of pressure support and at clinical stability
Changes in regional perfusion distribution
Changes in regional perfusion distribution between the two different levels of pressure support ("high" level of pressure support and "low" level of pressure support)
Time frame: Measured after at least 20 minutes from the application of each of the levels of pressure support and at clinical stability
Plan to share: No
This study is status unknown, as verified in Mar 2023. You cannot join it, but the record below documents what was studied.
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Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone Palermo