ARDS
Conditions
Interventions
Observation group:None
Sponsors
Zhongnan Hospital of Wuhan University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Patients with severe ARDS receiving mechanical ventilation and VV-ECMO treatment. 2.Patients with an anticipated duration of mechanical ventilation plus VV-ECMO treatment for more than 48 hours.
Exclusion criteria
Exclusion criteria: 1.Age 35 kg/m^2; 3.Pregnant women; 4.Contraindications to EIT monitoring (e.g., cardiac pacemaker or implantable cardioverter defibrillator (ICD) implantation, Electrode-site skin infection/open wounds, severe hypernatremia, on electrical stimulation therapy.); 5.Contraindications to prone positioning (e.g., spinal or pelvic fractures, severe hemodynamic instability, malignant arrthythmia, severely elevated intracranial pressure (ICP) or intraocular pressure (IOP), severe intra-abdominal hypertension(IAH), multiple bilateral rib fractures).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The ventilation-perfusion matching status at target achievement during the first prone positioning.; | — |
Secondary
| Measure | Time frame |
|---|---|
| the change of VQ match status during the second to fourth PP(Match1,Dead1,Shunt1,Match2,Dead2,Shunt2);the change of ventilation and gas exchange indices during the first to fourth PP (OI,PaCO2);the change of Respiratory mechanics indices during the first to fourth PP (Cst, mPaw Ri);Duration of ECMO support;the change of ventilation distribution characteristics during the first to fourth PP (LPB, GI, COV, Ventral and Dorsal ventilation ratio, ROI1, ROI2, ROI3 and ROI4 ventilation ratio).;the change of pulmonary perfusion parameter during the first to fourth PP (HPB);the change of macrohemodynamic parameters during the first to fourth PP (HR,MAP, NEE, CO and CI);the change of Oxygenation indicators during the first to fourth PP(SpO2).;the change of oxygen delivery and consumption indices during the first to fourth PP (DO2, VO2, DO2I, VO2I and O2ER);the change of systemic perfusion indices during the first to fourth PP (lac);the change of sublingual microcirculation parameters during the first to fourth PP (De Backer Score, TVD, PPV, PVD, MFI and HI);the change of ECMO operational monitoring metrics during the first to fourth PP (SpreO?, Hb, Ppre, Ppost , ?P and Pinlet);Prognostic indicators: all-cause 28-day mortality, successful ECMO weaning rate, duration of mechanical ventilation, duration of ventilator-free within 28 days, length of ICU stay, length of hospital stay, duration of receiving ECMO, and adjunctive therapies use (glucocorticoids, continuous renal replacement therapy, neuromuscular blocking agents, and tracheotomy rate); | — |
Countries
China
Contacts
Public ContactBo Hu
Zhongnan Hospital of Wuhan University
Outcome results
None listed