Acute Respiratory Distress Syndrome (ARDS) Acute Respiratory Distress Syndrome, Ventilation/Perfusion Matching, Electrical Impedance Tomography, Passive Leg Raising, Pulmonary Blood Flow, PEEP Titration
Conditions
Interventions
Adult patients diagnosed with Acute Respiratory Distress Syndrome (ARDS) according to the Berlin Definition, who are admitted to the Intensive Care Unit and have a clinical indication for PEEP titrati
Basic Science
Sponsors
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Diagnosed with ARDS according to the Berlin Definition. 2. Clinical indication for PEEP titration as determined by the attending medical team.
Exclusion criteria
Exclusion criteria: 1. Contraindication or inability to perform the Passive Leg Raising (PLR) test (including: suspected deep vein thrombosis, unstable pelvic/spinal/lower limb fractures, recent lower limb or abdominal surgery, known intra-abdominal hypertension, known intracranial hypertension). 2. Pregnancy. 3. Presence of a cardiac pacemaker or Implantable Cardioverter-Defibrillator (ICD). 4. Presence of intercostal chest drainage. 5. Severe chest trauma. 6. Moribund patients or a decision for palliative care. 7. Inability to obtain informed consent from the patient or Legally Authorized Representative.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Correlation between global change in End-Expiratory Lung Impedance (Global EELi) and change in PaO2/FiO2 ratio At baseline (T_base) and at final assessment at optimal PEEP (T_optimal Measured by Electrical Impedance Tomography (EIT) during Passive Leg Raising (PLR) test and Arterial Blood Gas (ABG) analysis | — |
Secondary
| Measure | Time frame |
|---|---|
| Correlation between regional change in End-Expiratory Lung Impedance (Regional EELi) and PaO2/FiO2 ratio in different lung zones Comparison between baseline assessment (T_base) and final assessment at optimal PEEP (T_optimal) Measured by EIT data from 4 regional zones during PLR test and Arterial Blood Gas (ABG) analysis,Correlation between regional EELi and hemodynamic parameters Comparison between baseline assessment (T_base) and final assessment at optimal PEEP (T_optimal) Measured by EIT data from 4 regional zones during PLR test and data from hemodynamic monitor (e.g., Cardiac Output, MAP),Correlation between EELi and respiratory mechanics Comparison between baseline assessment (T_base) and final assessment at optimal PEEP (T_optimal) Measured by EIT data from 4 regional zones during PLR test and data from the mechanical ventilator (e.g., Driving Pressure, Pplat) | — |
Countries
Thailand
Contacts
Public ContactPongdhep Theerawit
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Outcome results
None listed