ARDS (Acute Respiratory Distress Syndrome)
Conditions
Keywords
ARDS, inhaled nitric oxide
Brief summary
This study aimed to quantitatively evaluate the immediate effect of inhaled nitric oxide on the ventilation / perfusion ratio in ARDS patients receiving nasal high flow oxygen therapy or noninvasive ventilation using electrical impedance tomography.
Detailed description
The immediate effect of different doses of iNO (5-40 ppm) on the degree of v/q mismatch in the lungs of ARDS patients receiving hfnc or NIV was quantitatively evaluated by EIT. Objective to explore the effects of different doses of iNO on oxygenation, ventilation distribution and perfusion distribution in ARDS patients using hfnc or NIV, as well as the differences and influencing factors of individual response.
Interventions
DEVICEInhale different doses of nitric oxide
T0 (baseline): 20 to 30 minutes after initial stabilization; T1 (iNO 5ppm 1h): The patient non invasively inhales 5ppm NO for 1h. If the reaction standard (PaO2/FiO2 improvement ≥ 20%) is met, maintain the dose until the end of the study. Otherwise, continue to double the NO concentration and proceed with the following steps:; T2 (iNO 10ppm 1h): The patient non invasively inhales 10ppm of NO for 1h. If the reaction standard is met, maintain the dose until the end of the study, otherwise continue to double the NO concentration and proceed with the following steps; T3 (iNO 20ppm 1h): The patient non invasively inhales 20ppm NO for 1h. If the reaction standard is met, maintain the dose until the end of the study, otherwise continue to double the NO concentration and proceed with the following steps; T4 (iNO 40ppm 1h): The patient non invasively inhales 40ppm NO for 1h. All subjects completed the evaluation regardless of whether they met the response criteria.
Sponsors
Ming Zhong
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Age ≥ 18 years, gender unlimited; 2. Non invasive ventilation (NIV) with PEEP or CPAP ≥ 5 cmH2O or nasal high flow oxygen therapy (hfnc) with flow rate ≥ 30 l/min met the diagnostic criteria of non intubated ARDS according to the new global definition of ARDS: pao2/fio2 ≤ 300MMHG or spo2/fio2 ≤ 315 (SpO2 ≤ 97%); 3. Patients with spontaneous breathing and clear consciousness can cooperate with instructions and hold breath for ≥ 8s; 4. Patients with spontaneous breathing and clear consciousness can cooperate with instructions and hold breath for ≥ 8s;
Exclusion criteria
1. There are signs of worsening respiratory failure requiring immediate intubation: respiratory rate \> 40 times / min with severe use of auxiliary respiratory muscles or contradictory breathing, or Paco ₂ \> 50 mmHg and pH \< 7.25; 2. Hemodynamic instability or the presence of refractory shock; That is, the vasoactive drugs increased by more than 30% within 6 hours, or the norepinephrine dose exceeded 0.5 μ g /kg/min; 3. There are contraindications to EIT monitoring, such as thoracic implantable defibrillator / pacemaker, large area of severe skin damage on the chest, serious allergy to electrode patches, etc; 4. There are contraindications to the use of iNO: such as severe left ventricular dysfunction, active bleeding, etc; 5. Patients with intracranial hypertension, severe arrhythmia or digestive tract obstruction; 6. Pneumothorax and massive pleural effusion were not treated; 7. Chronic kidney disease; 8. Pregnant or lactating women; 9. Participating in other studies; 10. The investigator judged that there were any other circumstances not suitable for participation in this study. -
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oxygenation index | baseline, before intervention; Time point 1: After inhaling 5ppm of NO for 1 hour; Time point 2: After inhaling 10ppm of NO for 1 hour; Time point 3: After inhaling 20ppm of NO for 1 hour; Time point 4: After inhaling 40ppm of NO for 1 hour | Blood gas analyzer was used for analysis after arterial extraction |
| Ventilation/perfusion ratio | baseline, before intervention; After inhaling 5ppm of NO for 1 hour; After inhaling 40ppm of NO for 1 hour | Electrical impedance tomography |
Countries
China
Contacts
CONTACTDang Xinya Dang Xinya, bachelor
CONTACTLiu Kai Liu Kai, bachelor
PRINCIPAL_INVESTIGATORLiu Kai Liu Kai, bachelor
Fudan University
STUDY_CHAIRDang Xinya Xinya Dang, bachelor
Fudan University
STUDY_DIRECTORZhong Ming Ming Zhong, doctor
Fudan University
Outcome results
None listed