ARDS, Coronavirus Disease 2019, Mechanical Ventilation Pressure High
Conditions
Brief summary
Prone positioning improves oxygenation in patients with ARDS (1-3). Patients with severe ARDS due to COVID-19 are candidates for prone position. It should be started within 36-48 h and maintained 1, 3). Prone ventilationARDS based on a randomized trial that showed a mortality benefit (PROSEVA) (3). The improvement of oxygenation occurs by making ventilation more homogeneous, limiting ventilator-associated lung injury (4-6). Prone positioning was as effective in improving oxygenation, static respiratory system compliance (Crs) (7). Higher PEEP should be applied when there is a high recruitability potential of the lung. This study aimed to investigate whether prone positioning changes the recruitability position of the lung.in COVID-ARDS.
Detailed description
Prone positioning improves oxygenation in patients with ARDS (1-3). Patients with severe ARDS due to COVID-19 are candidates for prone position. It should be started within 36-48 h and maintained 1, 3). Prone ventilationARDS based on a randomized trial that showed a mortality benefit (PROSEVA) (3). The improvement of oxygenation occurs by making ventilation more homogeneous, limiting ventilator-associated lung injury (4-6). Prone positioning was as effective in improving oxygenation, static respiratory system compliance (Crs) (7).Higher PEEP should be applied when there is a high recruitability potential of the lung. This study aimed to investigate whether prone positioning changes the oxygenation, respiratory mechanics and recruitability position of the lung in COVID-ARDS.
Interventions
OTHEROxygenation
Oxygenation will be calculated as PaO2/ FiO2 ratio.Static compliance will be calculated as tidal volume divided driving pressure.The potential for lung recruitment will be assessed by means of the R/I ratio (10).
Sponsors
Tepecik Training and Research Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients with laboratory-confirmed COVID-19 admitted to the ICU * The patients receive invasive mechanical ventilation and meet the criteria for ARDS (Berlin definition) (8), with under continuous infusion of sedatives,
Exclusion criteria
* Pregnancy * Pneumothorax and or chest tube * Chronic obstructive lung disease * interstitial lung disease * intraabdominal hypertension * increase in intracranial blood pressure * Haemodynamic unstability requiring vasopressors
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oxygenation | intubation + 48 hours | PaO2/FiO2 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Static compliance | intubation + 48 hours | Tidal volume divided driving pressure |
| Recruitability | intubation + 48 hours | recruitment to inflation ratio |
Countries
Turkey (Türkiye)
Contacts
Primary ContactKAZIM ROLLAS
Backup ContactÖMER EMGİN
Outcome results
None listed