Acute Respiratory Distress Syndrome
Conditions
Keywords
Position patient, Esophageal pressure
Brief summary
Esophageal pressure measurements are used in moderate/severe Accurate Respiratory Distress SyndromeARDS patients in order to set ventilator settings. There might be variations of the measured value according to the patient position (0° vs 30°) at the time of measurements.
Interventions
OTHERhead-bed position
Head-bed position at 0° for 30 minutes then head-bed position at 30° for 30 minutes
Sponsors
Hospices Civils de Lyon
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Acute respiratory failure defined by PaO2/FIO2\< 300 mmHg or pH\<7,35 and pCO2\>45mmHg or Moderate or severe Accurate Respiratory Distress Syndrome ARDS defined by: * New or worsening respiratory symptoms in the previous week. * Bilateral opacities-not fully explained by effusions, lobar/lung collapse, or Nodules * Respiratory failure not fully explained by cardiac failure or fluid overload * PaO2/FIO2\< 200 mmHg and PEEP ≥ 5 cm H2O and VT ≤6 ml/kg of Ideal Body Weight * Patient intubated or tracheotomized and receiving mechanical ventilation * Indication of esophageal measurement decided by the clinician
Exclusion criteria
* Contraindication to naso-gastric tube insertion : * Recent gastro-duodenal ulcer * Stage III esophageal varices * Refractory intracranial hypertension * Unstabilized spine fracture * Surgical contraindication * Burns on more than 20 % of the body surface * Underlying disease with a life expectancy of less than one year * End-of-life decision before inclusion * Pregnant or breast-feeding patients * Subject deprived of freedom, minor, subject under a legal protective measure * Research team unavailability * Lack of medical care plan
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total End-expiratory esophageal pressure | 30min after change of position | After end-expiratory pause on the ventilator, absolute value of the esophageal pressure is measured (in Head-bed position at 30° then in head-bed position at 0° ) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| End-inspiratory esophageal pressure | 30min after change of position | After end-inspiratory pause on the ventilator, absolute value of the esophageal pressure is measured (in Head-bed position at 30° then in head-bed position at 0° ) |
| Gastric pressure | 30min after change of position | After end-expiratory pause and end-inspiratory pause on the ventilator, absolute value of the gastric pressure is measured (in Head-bed position at 30° then in head-bed position at 0° ) |
| End-expiratory lung volume | 30min after change of position | End-expiratory lung volume is measured with nitrogen wash-in wash-out method, available in the ventilator (in Head-bed position at 30° then in head-bed position at 0° ) |
Countries
France
Outcome results
None listed