ARDS
Conditions
Brief summary
The use of esophageal balloon catheter to estimate pleural pressure has gained renewed popularity in recent years. Indeed, measurement of transpulmonary pressure may allow a more pathophysiological-based approach to ventilator strategy in acute respiratory distress syndrome (ARDS) patients. Nevertheless, it is well known that esophageal balloon catheter derived parameters can be influenced by several patient-related or technical-related factors. During a PEEP trial, the investigators will observe in-vivo the esophageal pressure and derived measurements obtained using different esophageal balloon calibration volumes.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Diagnosis of ARDS with a PEEP of at least 8 cmH2O * Fraction of inspired oxygen not higher than 80% * Intubated and ventilated in Volume Control Ventilation mode set by the attending physician according to clinical criteria * Need of continuous sedation through intravenous anesthetics and full neuromuscular blockade
Exclusion criteria
* Been pregnant or breastfeeding * Hemodynamic instability * Presence of tracheobronchial fistula * Known pneumothorax * Leak in airway circuitry * Presence of any kind of inhalator therapy (e.g. Heliox, nitric oxide, anesthetic conserving device) * Recent history of nasal trauma or lesion of nasal cavity * Recent history of esophageal, gastrointestinal, ENT, thoracic or cardiac surgery (less than 2 months) * Known or suspected esophageal varices * Congenital, acquired or drug-induced hemostatic disorder * Thrombocytopenia (less than 50000/mm3) * Recent history of Traumatic Brain Injury or thoraco-abdominal trauma (less than 1 months) * Rib or sternal fractures
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| transpulmonary pressure measured estimating pleural pressure through the esophageal balloon | within 10 minutes after esophageal balloon volume changing |
Secondary
| Measure | Time frame |
|---|---|
| End-expiratory lung volume | within 60 minutes after PEEP changing |
Countries
Italy