An observational study in Acute Respiratory Distress Syndrome, Mechanical Ventilation and Prone Positioning, sponsored by West China Hospital. Recruiting at 1 site in China. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2025-03-03.
Sponsored by West China Hospital · Observational
The purpose of this study is to observe the changes of physiological indicators such as ventilation and oxygenation in the prone position of ARDS patients, to observe the change trend of each patient's indicators, and to observe whether different trends of indicators predict different prognosis of patients.
PP has been shown to effectively improve the prognosis of patients with severe ARDS, but not all patients with ARDS can benefit from PP, and the implementation of the PP has a certain clinical risks and side effects, we lack a convenient predictors to guide doctors to determine whether patients should implement the PP. Clinical usually observe the P/F improved as whether PP treatment effective reference, but there are literature points out that the rising P/F after PP can not predict the better prognosis. one of the mechanisms for ARDS patients benefit from PP is proved to be improve V/Q, the change of the V/Q may determine whether the PP treatment effectively is an important indicator. PaO2:FiO2 ratio was usually used to evaluate the effect of PP, but some studies did not support this conclusion. PP has been shown to change ventilation-perfusion ratio, dead space may be better physiological indicators, simplify dead space ratio and Ventilatory ratio can be easily accessed at bedside and is associated with mortality of patients with ARDS. The purpose of this study is to observe the predictive value of P/F, VD-etCO2/VT, and VR on the treatment effect of ARDS undergoing PP.
1,596 studies on the registry are indexed under Respiratory Distress Syndrome; 312 are open to participants now.
This study's planned enrollment of 100 is close to the median of 100 across 540 observational studies indexed under Respiratory Distress Syndrome.
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We conducted a prospective cohort study in a intensive care unit in West China Hospital, Sichuan University, China. Adult patients (age≥18years) who were diagnosed with moderate to severe ARDS according to the Berlin definition, received mechanical ventilation and prone positioning were included.
Exclusion Criteria:
28 days without mechanical ventilation
Days without mechanical ventilation support within 28 days after enrollment
Time frame: From the date of enrollment to 28 days
ICU mortality and in-hospital mortality
Prognostic measures will be recorded until discharge, such as ICU mortality and in-hospital mortality
Time frame: From the date of enrollment until the date of discharge, assessed up to 1 year
Length of lCU stay and length of hospital stay
Prognostic measures will be recorded until discharge, such as length of lICU stay and length of hospital stay in days.
Time frame: From the date of enrollment until the date of discharge, assessed up to 1 year.
Respiratory physiological parameters.
Respiratory physiological parameters are collected at each time point (before prone positioning , every 4 hours after prone positioning, and 4 hours after turn back to supine position), such as PaO2/FiO2。
Time frame: From enrollment to Day 7.
Indicators related to dead space
Indicators related to dead space are collected at each time point (before prone positioning , every 4 hours after prone positioning, and 4 hours after turn back to supine position), such as VR and dead space ratio, which were calculated by predicted body weight, partial pressure of carbon dioxide and end-tidal carbon dioxide
Time frame: From enrollment to Day 7.
Plan to share: Yes — Any data collected during this study can be acquired from the correspondingauthor upon a reasonable request.
Supporting information: Csr
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