Acute Respiratory Distress Syndrome, Extracorporeal Membrane Oxygenation, Mechanical Power, Transpulmonary Mechanical Power
Conditions
Brief summary
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a salvage treatment for severe acute respiratory distress syndrome (ARDS). With the large-scale implementation of VV-ECMO in critical care medicine departments in China, significant progress has been made in treating severe ARDS. However, the patient mortality rate remains high. The pathophysiological essence of ARDS is an imbalance between the body's oxygen supply and demand, causing tissue and cell hypoxia, organ dysfunction, and even death. The VV-ECMO treatment process still requires mechanical ventilation assistance. However, inappropriate mechanical ventilation settings can lead to ventilator-related lung injury (VILI). In recent years, mechanical power has gradually attracted everyone's attention and is considered the cause of VILI. The transpulmonary mechanical power is more accurate to the energy directly performed to the lung tissue. Transpulmonary mechanical energy has a specific value in judging the prognosis of mechanically ventilated patients, but its clinical significance in treating patients with VV-ECMO is unclear. This study aimed to explore the value of transpulmonary mechanical power in predicting the prognosis of patients with severe ARDS patients treated with VV-ECMO.
Interventions
PROCEDURETranspulmonary pressure
Use transpulmonary pressure to guide ventilator setting in ECMO for severe ARDS patients.
Sponsors
Beijing Chao Yang Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Inclusion criteria
1. Meet the diagnostic criteria of Berlin's definition for ARDS; 2. Receiving VV-ECMO support.
Exclusion criteria
1. Patients had been on high pressure (Ppeak \>35 cm H2O) and a high fraction of inspired oxygen (FiO2\>0.8) ventilation for \>7 days; 2. Patients had a contraindication to heparinization; 3. Patients had an irreversible neurological injury; 4. Patients had severe chronic lung disease with life expectancy \<6 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patients successfully weaned from VV-ECMO | After patients enrolled 60 days | Weaning VV-ECMO more than 48 hours with stable oxygenation and no need to re-establish ECMO |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 60-day mortality | After patients enrolled 60 days | Mortality rate at 60 days of VV-ECMO support |
Countries
China
Contacts
Primary ContactYu Zhao, Dr.
Outcome results
None listed