COVID-19 Acute Respiratory Distress Syndrome
Conditions
Keywords
Interleukin-6, Acute Respiratory Distress Syndrome, COVID-19
Brief summary
In the current COVID-19 pandemic, many patients have an acute respiratory distress syndrome (ARDS). Among mechanisms related to COVID-19 acute respiratory distress syndrome, cytokine storm and secretion of IL-6 play a central role. ARDS management involves intubation for protective mechanical ventilation, deep sedation and curarisation. During intensive care unit (ICU) hospitalization, improvement of hematosis induces a switch from a controlled ventilation mode to a withdrawal ventilation mode, such as Spontaneous Ventilation with Pressure Support (SP-PS) or Adaptative Support Ventilation (ASV). This step is essential prior to considering complete weaning from controlled ventilation and sometimes ends with a failure. In this case, deterioration of hematosis and/or ventilatory mechanics is observed. At the same time as withdrawal failure, the investigators observed biological inflammatory rebound in some patients. Therefore, influence of inflammatory biological parameters, including IL-6, on withdrawal failure, needs to be investigated. To this end, the investigators decide to dose different inflammatory markers - such as IL6, C-Reactive Protein (CRP), Procalcitonin (PCT) - in patients with acute respiratory distress syndrome due to COVID-19, during standard of care. Indeed, in patients with acute respiratory distress syndrome not due to COVID-19, the increase in IL6 is a negative prognosis during medical first aid but also when the mechanical ventilation is withdrawn. In addition, IL6 rise is associated with poor prognosis for patients with COVID-19 and longer stays in intensive care.
Interventions
BIOLOGICALIL6 assessment
Blood IL6 will be assessed during trial
BIOLOGICALCRP and PCT assessment
Blood CRP and PCT will be assessed during trial
Sponsors
Centre Hospitalier Henri Duffaut - Avignon
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 * Patients with COVID-19 (positive COVID PCR) * Use of intubation for mechanical ventilation
Exclusion criteria
* Use of Extracorporeal Membrane Oxygenation * Treatment with Tocilizumab (anti-Il6) * Pregnant woman * Patients under protective administration or deprived of liberty
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Serum concentration of IL6 | Up to 72 hours after the start of respiratory weaning | Change of blood IL6 concentration during switch from a controlled ventilation mode to a weaning ventilation mode in COVID-19 patients |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pulmonary wedge pressure | Up to 48 hours after the start of respiratory weaning | Change of pulmonary wedge pressure (in mmHg), respiratory rate (in breaths per minute), Fraction of inspired oxygen (FiO2, in percentage), Tidal Volume (in ml/kg) during switch from a controlled ventilation mode to a weaning mode in COVID-19 patients |
| Respiratory rate | Up to 48 hours after the start of respiratory weaning | Change of respiratory rate (in breaths per minute) during switch from a controlled ventilation mode to a weaning mode in COVID-19 patients |
| Fraction of inspired oxygen | Up to 48 hours after the start of respiratory weaning | Change of Fraction of inspired oxygen (FiO2, in percentage) during switch from a controlled ventilation mode to a weaning mode in COVID-19 patients |
| Serum concentration of CRP and PCT | Up to 48 hours after the start of respiratory weaning | Change of blood CRP et PCT concentration during switch from a controlled ventilation mode to a weaning mode in COVID-19 patients |
| Days of mechanical ventilation | At the start of respiratory weaning | Duration of mechanical ventilation (days) |
| Number of ventral decubitus | At the start of respiratory weaning | Number of ventral decubitus during mechanical ventilation mode |
| Tidal Volume | Up to 48 hours after the start of respiratory weaning | Change of Tidal Volume (in ml/kg) during switch from a controlled ventilation mode to a weaning mode in COVID-19 patients |
Countries
France
Outcome results
None listed