Respiratory Distress Syndrome
Conditions
Keywords
ARDS, ECMO, diaphragm function
Brief summary
Use of veno-venous extracorporeal oxygenation membrane is a therapeutic option for the management of the most severe patients with acute respiratory distress syndrome (ARDS). Given the prolonged duration of this strategy, the question of its impact on the occurrence on diaphragm dysfunction has been raised. The present study endeavors to evaluate and follow up the prevalence, risk factors and prognosis of diaphragm dysfunction in patients with VV-ECMO.
Detailed description
Use of veno-venous extracorporeal oxygenation membrane is a therapeutic option for the management of the most severe patients with acute respiratory distress syndrome (ARDS). It allows to provide a protective lung ventilation by reducing the level of airway pressures generated by the ventilator. The objective is to minimize the harmful effects of mechanical ventilation in the lungs and to provide adequate gases exchanges. This strategy requires a deep sedation to allow a perfect synchrony between the patient and the ventilator. Such a synchrony puts the respiratory muscles - in particular the diaphragm - completely at rest. Given the prolonged duration of this strategy, the question of its impact on the occurrence on diaphragm dysfunction has been raised. Such a dysfunction has been associated with prolonged duration of mechanical ventilation and poor outcomes but its effect in patients with veno-venous extracorporeal oxygenation membrane has never been evaluated so far.
Interventions
DEVICEdiaphragmatic function measurements and diaphragmatic ultrasound
A single experimental group in which diaphragmatic function measurements and diaphragmatic ultrasound will be performed.
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age \> 18 years * ARDS according to the Berlin definition * V-V ECMO * patient or next of kin agrees to participate * patient with health insurance
Exclusion criteria
* pregnancy * Opposition to participate * Contra indications to the phrenic nerves stimulation technique (pace maker, pneumothorax)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diaphragm function | until day 28 | as defined by the pressure generating capacity of the diaphragm \< 11 cmH2O |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of ECMO | until day 60 | from inclusion until ECMO removal |
| Duration of invasive mechanical ventilation | until day 60 | from inclusion until extubation |
Countries
France
Outcome results
None listed