ARDS
Conditions
Keywords
ARDS, mechanical ventilation, EIT
Brief summary
ARDS is a frequent reason for hospitalization in intensive care. In order to improve its management, doctors seek to limit the mechanical ventilation-induced injuries (VILI) that can occur. PEEP is a parameter that plays a role in the appearance of VILI, and its adjustment can be optimized by EIT. The EIT is a non-invasive, non-irradiating, real-time monitoring device, today widely used for the optimization of ventilation in patients intubated for ARDS. The positioning of the EIT belt at different chest heights could influence the result of the PEEP titration.
Detailed description
The aim of this study is to test the hypothesis that the position (2nd intercostal space or 5th intercostal space) of the EIT (Electrical Impedance Tomography) belt significantly influences the result of PEEP (Positive Expiratory Pressure) titration.
Interventions
DEVICEEIT
Two PEEP titrations monitored by EIT will be performed, each with the electrode belt positioned at a different chest height (2nd intercostal space or 5th intercostal space). The order will be drawn at random.
Sponsors
Centre Hospitalier Saint Joseph Saint Luc de Lyon
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
Once the patient is included in the research, two PEEP titrations monitored by EIT will be performed, each with the electrode belt positioned at a different chest height. The order will be drawn at random.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Occurrence of moderate to severe ARDS (PaO2/FiO2 ratio ≤ 200 mmHg) within 72 hours following intubation * Criteria for moderate to severe ARDS for less than 72 hours * Passive ventilation in controlled assisted ventilation (no spontaneous ventilation) * Consent of next of kin
Exclusion criteria
* Age \< 18 years * ECMO * Pneumothorax * Pacemaker or implantable defibrillator * Chest trauma in the last 3 months * Skin peeling (Burned, Lyell) * Intracranial hypertension * Uncontrolled shock (noradrenaline \>5 mg/h) * Pregnant woman * Adult patient protected within the meaning of the law * Lack of social security
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Impact of the position of the electrode belt on the results of PEEP titration by EIT. | Day 0 | Optimal PEEP determined by PEEP titration using the crossing point method. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Impact of the existence of intra-tidal recruitment on the discordance between PEPEIT and PEPCRS | Day 0 | Variability of the impedance variation during insufflation of the tidal volume (tidal impedance variation) during titration measured by the relative interquartile coefficient (Q3-Q1)/median |
| Factors associated with a discordance between PEPEIT and PEPCRS | Day 0 | Variability of the impedance variation during insufflation of the tidal volume (tidal impedance variation) during titration measured by the relative interquartile coefficient (Q3-Q1)/median |
| Discrepancy between compliance measured according to impedance and compliance measured according to exhaled volume | Day 0 | Regional ventilation delay (RVD) |
Contacts
Primary ContactSamuel Tuffet, MD
Backup ContactFanny Doroszewski, Mrs
Outcome results
None listed