ARDS, Respiratory Failure
Conditions
Keywords
ARDS, EIT, 3D-EIT
Brief summary
In a population of ARDS patients, we explore the influence of different PEEP levels on regional ventilation distribution, ventilation homogeneity, and the center of ventilation, optimal PEEP and lung recruitment potential as well as the extent of lung collapse and overdistension as detected by 3D-EIT.
Interventions
PROCEDURElung recruitment potential assessed by 3D EIT
Patients were ventilated based on the ARDS-Net suggestions. The patients were kept at supine position. The lung recruitment potential assessed by 3D EIT was as follows: 1. All patients were under pressure control mode (driving pressure 12-15 cmH2O with a tidal volume of 6-8 ml/kg predicted body weight, respiration rate12-15 bpm). 2. PEEP was switched to a zero end-expiratory pressure (ZEEP) for 10 min, and FiO2 was titrated to obtain peripheral oxygen saturation (SpO2 ) > 90%. 3. PEEP was stepwise increase from 0 to 15 cmH2O PEEP in steps of 5cm H2O every 3min.And 3D EIT was used to assess lung recruitment potential.
PROCEDUREPEEP titration by 3D eit
Patients were ventilated based on the ARDS-Net suggestions. The patients were kept at supine position. The PEEP titriatino by 3D EIT fwas as follows: 1. All patients were under pressure control mode (driving pressure 12-15 cmH2O with a tidal volume of 6-8 ml/kg predicted body weight, respiration rate12-15 bpm). 2. RM: PEEP was switched to a 21cmH2O for 2min, and FiO2 was titrated to obtain peripheral oxygen saturation (SpO2 ) ≥90%. 3. PEEP was stepwise decrease from 21 to 0 cmH2O PEEP in steps of 3cm H2O every 2min. 4. 3D EIT was used to monitor regional ventilation distribution during PEEP titration.
Sponsors
Peking Union Medical College Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients on mechanical ventilation. * Diagnosis of ARDS was based on the Berlin definition * lung recruitment potential assessment and PEEP titration was proper for the ARDS patients determined by the attending doctor
Exclusion criteria
* Under 18 years of age. * Pregnant women; * Ribcage malformation * Any contraindication to the use of EIT (e.g. automatic implantable cardioverter defibrillator, and implantable pumps). * Hemodynamic instability, unable to tolerate high PEEP; * High-risk individuals with pneumothorax, mediastinal emphysema, etc.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| OD/CL and optimal PEEP monitored by EIT | 5-10min | Monitoring the lung collapse and overdistension region by EIT at different PEEP levels. Measure the optimal PEEP level based on collapse and overdistension rate. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ventilation distribution monitored by EIT | 5-10min | Monitoring the lung ventilation distribution by EIT at different PEEP levels |
| GI monitored by EIT | 5-10min | Global Inhomogeneity (GI) Index monitored by EIT at different PEEP levels |
| CoV monitored by EIT | 5-10min | Center of ventilation (COV) monitored by EIT at different PEEP levels |
| V/Q monitored by EIT | 5-10min | Ventilation and perfusion monitored by EIT at different PEEP levels. To evaluate the V/Q match, deadspace and shunt lung region. |
Countries
China
Contacts
Primary ContactHuaiwu He
Outcome results
None listed