ARDS
Conditions
Interventions
intervention group:After the optimal PEEP and tidal volume were titrated according to the above methods, driving pressure, end-inspiratory plateau pressure (Pplat), respiratory system static complianc
control:Small tidal volume of lung protective ventilation strategy
Sponsors
The Affiliated Hospital of Guizhou Medical University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: (1) ARDS patients meeting the Berlin definition requiring invasive mechanical ventilation: A. onset time: clinical etiology known or within 1 week after new/existing respiratory symptoms aggravate; B. the chest imaging: chest X-ray or CT scan, visible shadows and cannot be completely explained in pleural effusion on both sides, lung/collapsed lung, nodules; C. pulmonary edema: the reason for this could not be explained by heart failure or water load increase of respiratory failure, if there is no risk factors, be objective assessment rule out hydrostatic edema; d. Degree of hypoxia: (1) mild: 200 MMHG < PaO2 / FiO2 300 MMHG, or less PEEP or CPAP acuity 5 cmh2o, mild ARDS group may use noninvasive ventilation; (2) moderate: 100 MMHG < PaO2 / FiO2 or less 200 MMHG, PEEP five or more cmh2o. ? Severe: PaO2/FiO2=100mmHg, PEEP=5cmH2O. (2) adults over 18 years of age; (3) into the comprehensive ICU and mechanical ventilation time less than 48 hours.
Exclusion criteria
Exclusion criteria: (1) expected to be weaned from mechanical ventilation within 24 hours; (2) previous history of neuromuscular diseases (including diaphragmatic paralysis); (3) severe obstructive pulmonary disease; Pulmonary bullae, subcutaneous emphysema and pneumomediastinum or pneumothorax. (4) pregnancy; (5) obese (BMI) 35 kg/m2 or; (6) severe hemorrhagic disease (including pulmonary vascular diseases such as hemorrhage, cerebral hemorrhage). (7) agonal state or terminal stage of illness; (8) disturbance of consciousness or intracranial hypertension caused by various reasons; (9) hematological diseases, bone marrow transplantation; (10) Cardiac function serious obstacle (New York heart association levels ? or ?, acute coronary syndrome makes good or sustained ventricular arrhythmias); (11) after cardiogenic shock or major cardiac surgery; (12) patients with mental disorders or immunodeficiency; (13) refractory shock (though fully liquid recovery, using large dose of vascular active drugs: norepinephrine equivalent dose > 1 ug/kg/min, the MAP is < 65 MMHG); (14) partial use of neuromuscular tissue agents; (15) for patients receiving ECMO; (16) patients with massive ascites and significantly increased abdominal pressure; (17) The family members did not provide informed consent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Duration of invasive mechanical ventilation; | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of diaphragmatic dysfunction;28 days without mechanical ventilation;Length of ICU stay;length of stay;The hospital mortality;Incidence of barotrauma; | — |
Countries
China
Contacts
Public ContactFeng Shen
The Affiliated Hospital of Guizhou Medical University
Outcome results
None listed