Electrical Impedance Tomography for Optimization of Positive End-Expiratory Pressure: Acute Respiratory Distress Syndrome
Study Details
Study Description
Brief Summary
Doctors follow a standard ventilator management strategy when making adjustments to the breathing machine to optimize the amount of oxygen into the lungs. The purpose of this study is to assess whether the EIT (electrical impedance tomography) device can be an additional useful tool for ventilator management and identifying the ideal positive end-expiratory pressure (PEEP).
Condition or Disease | Intervention/Treatment | Phase |
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|
N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Usual care then PEEP titration by EIT Patients in the usual care first group will continue to receive mechanical ventilation according to the University of Michigan ARDS protocol high-PEEP arm |
Other: Usual care
Intervention is the standard basic lung protective ventilation strategy used at the University Hospital Respiratory Care at Michigan Medicine.
Device: PEEP titration by EIT
PEEP Titration procedure involves two phases: a recruitment phase followed by a gradual reduction in the end-expiratory pressure phase (Decremental PEEP).
Other Names:
|
Experimental: PEEP titration by EIT then usual care Patients in the high PEEP titration by EIT first will have receive ventilation with a PEEP determined by EIT titration procedure. |
Other: Usual care
Intervention is the standard basic lung protective ventilation strategy used at the University Hospital Respiratory Care at Michigan Medicine.
Device: PEEP titration by EIT
PEEP Titration procedure involves two phases: a recruitment phase followed by a gradual reduction in the end-expiratory pressure phase (Decremental PEEP).
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Change in lung inflammation as measured by physiologic parameter: Mechanical Power [Up to 24 hours]
Physiological parameter
Secondary Outcome Measures
- Change in lung inflammation as measured by physiologic parameter: Partial pressure of arterial oxygen (PaO2) [Up to 24 hours]
Physiologic parameter
- Change in lung inflammation as measured by physiologic parameter: Partial pressure of arterial oxygen/Fraction of Inspired Oxygen (P/F ratio) [Up to 24 hours]
Physiologic parameter
- Change in lung inflammation as measured by physiologic parameter: Plateau pressure [Up to 24 hours]
Physiologic parameter
- Lung inflammation as measured by physiologic parameter: Driving Pressure [Up to 24 hours]
Physiologic parameter
- Change in lung inflammation as measured by physiologic parameter: Static compliance [Up to 24 hours]
Physiologic parameter
Eligibility Criteria
Criteria
Inclusion Criteria:
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Endotracheal ventilation for < 1 week (168 hours)
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Presence of all of the following conditions for < 48 hours i. PaO2/FiO2 < 150 with PEEP > 5 cm H2O for > 30 min. ii. bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules iii. respiratory failure not fully explained by cardiac failure or fluid overload
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All criteria listed in (3) developed within 1 week of a known clinical insult or new or worsening respiratory symptoms
Exclusion Criteria:
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Lack of informed consent
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Known pregnancy
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ECMO
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Severe chronic respiratory disease requiring home oxygen therapy or ventilation
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Calculated BMI of greater than 50
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | The University of Michigan | Ann Arbor | Michigan | United States | 48109 |
Sponsors and Collaborators
- University of Michigan
Investigators
- Principal Investigator: Robert Hyzy, MD, University of Michigan
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- HUM00148126