STRAIN: Detection of Right Ventricular Dysfunction by 2D Strain During Acute Respiratory Distress Syndrom (ARDS)
Study Details
Study Description
Brief Summary
Acute respiratory distress syndrome (ARDS) and mechanical ventilation can lead to right ventricular dysfunction and ultimately right ventricular failure by increasing pulmonary vascular resistances and pressure load. This can be prevented by modifying ventilator settings, using vasopressors or inotropes or even by prone positionning.But to do so, right ventricular dysfonction has to be detected. Echocardiography has emerged as a first line tool to diagnose right heart failure. Recently, strain analysis showed promising results to detect early right ventricle abnormalities in other settings such as pulmonary hypertension or scleroderma. We therefore decided to determine whether 2D strain could help detect early right ventricular dysfunction in ARDS.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| ARDS group Patients under mechanical ventilation since less than 24 hours at inclusion and presenting acute respiratory distress syndrome criteria. |
|
| ALI group Patients under mechanical ventilation and presenting acute lung injury criteria. |
|
| Control Group Patients under mechanical ventilation for a non-respiratory cause |
Outcome Measures
Primary Outcome Measures
- Right ventricle 2D strain [Duration of mechanical ventilation]
We will assess whether 2D strain can detect a right ventricular dysfunction as compared to standard echocardiographic parameters
Secondary Outcome Measures
- Mean right ventricle strain under ventilated patients [at inclusion]
We measure right ventricle strain (RV strain) in patients under mechanical ventilation for a non-respiratory cause. This allows us to determine the mean value of RV strain under ventilation when there is no respiratory failure.
- Reproducibility between transthoracic and transesophageal strain measures [Time of mechanical ventilation]
In ARDS patients, we record a transthoracic and transesophageal echocardiography. We compare RV strain values obtained from transthoracic and transesophageal echocardiography.
- NT pro BNP and pre pro endothelin plasma level [At inclusion in ARDS patients]
These assays are made based on the hypothesis they could help discriminate between patients who will develop a right ventricular dysfunction from those who will not. A blood sample is withdrawn at the same time as echocardiography only in the ARDS group.
Eligibility Criteria
Criteria
ARDS group
Inclusion Criteria:
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Need for mechanical ventilation
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ARDS criteria met: Respiratory failure not fully explained by cardiac failure, Pao2/FiO2<200, bilateral opacities on Chest imaging, all symptoms appeared within 1 week
Exclusion Criteria:
-
Predictable duration of mechanical ventilation shorter than 48 hours
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Contraindication to transesophageal echocardiography
ALI group:
Inclusion Criteria:
-
Need for mechanical ventilation
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ALI criteria met: Respiratory failure not fully explained by cardiac failure, Pao2/FiO2<300, bilateral opacities on Chest imaging, all symptoms appeared within 1 week
Exclusion Criteria:
- Predictable duration of mechanical ventilation shorter than 48 hours
Control Group:
Inclusion Criteria:
- Need for mechanical ventilation for a non-respiratory cause
Exclusion Criteria:
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Need for FiO2>30%
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Known cardiac abnormalities
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Cardiac drugs intake during last 24 hours
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University Hospital of Grenoble | Grenoble | Cedex 09 | France | 38043 |
Sponsors and Collaborators
- University Hospital, Grenoble
Investigators
- Principal Investigator: Carole SCHWEBEL, PU/PH, University Hospital, Grenoble
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2012-A01204-39