Ventilation-Perfusion Matching in Early-stage Prone Position Ventilation

Ventilation-Perfusion Matching in Early-stage Prone Position Ventilation: A Comparison Between COVID-19 ARDS and ARDS From Other Etiologies

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT05816928

Enrollment

Registered

2023-04-18

Start date

2021-01-12

Completion date

2021-04-12

Last updated

2023-04-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Respiratory Distress Syndrome

Keywords

Acute Respiratory Distress Syndrome, ICU, COVID19, Electrical impedance tomography

Brief summary

Prone positioning has been widely used in critical care medicine to improve oxygenation in patients with acute respiratory distress syndrome (ARDS). This study aimed to compare the effect of pronation on lung ventilation-perfusion matching between COVID19-associated acute respiratory distress syndrome (CARDS) and ARDS from other etiologies (non-CARDS) using electrical impedance tomography (EIT).

Detailed description

In this prospective study, both COVID19-associated ARDS (CARDS) patients and patients with ARDS from other etiologies (non-CARDS) were enrolled. Electrical impedance tomography (EIT) was used to evaluate the changes in ventilation and perfusion between supine and prone positions. Baseline values of the area of DeadSpace, shunt, ventilation-perfusion matching (VQmatch) were identified at the time of enrollment. Within the defined VQmatch region, the global inhomogeneity index (VQmatch-GI) was calculated to assess the degree of uniformity within the region. Prone position was applied immediately after the baseline data were collected. After 2 hours of proning, another EIT examination was conducted. Parameters such as DeadSpace, shunt, VQmatch, and other common measurements before and after pronation were taken and compared to evaluate the effect of prone positioning on CARDS and non-CARDS patients.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Above the age of 18 * Diagnosed with ARDS based on the Berlin Definition of ARDS * Under mechanical ventilation

Exclusion criteria

* Contraindications to EIT examination and prone position * Refusal of signing the informed consent

Design outcomes

Primary

Measure	Time frame	Description
Global inhomogeneity index (VQmatch-GI)	3 months	Within the defined VQmatch region assessed by electrical impedance tomography, the global inhomogeneity index (VQmatch-GI) was calculated to assess the degree of uniformity within the region.
DeadSpace	3 months	The area of Deadspace will be assessed using electrical impedance tomography
Shunt	3 months	Shunt will be assessed using electrical impedance tomography
Ventilation-perfusion matching (VQmatch)	3 months	VQmatch will be assessed using electrical impedance tomography

Secondary

Measure	Time frame	Description
Ventilation	3 months	The ventilation of the lungs is assessed by electrical impedance tomography before and after prone positioning.
Perfusion	3 months	The perfusion of the lungs is assessed by electrical impedance tomography before and after prone positioning.
Center of Ventilation (CoV)	3 months	The center of ventilation of the lungs is assessed by electrical impedance tomography before and after prone positioning.
Standard deviation of regional ventilation delay	3 months	The standard deviation of regional ventilation delay of the lungs is assessed by electrical impedance tomography before and after prone positioning.

Countries

China

Outcome results