The EVLW for Set the Positive End Expiratory Pressure (PEEP) in the Acute Respiratory Distress Syndrome (ARDS)

University Hospital, Strasbourg, France40 enrolled

Overview

* ARDS is a severe pathology with high mortality and morbidity.Actual ventilatory management is clear for the set of the tidal volume and for the survey of the plateau pressure for the patients who require mechanical ventilation. * The set of the PEEP (low or high levels) remains unclear : it seems that some patients need low levels of PEEP whereas anther need high levels; but there is no validated data that can discriminate them. * We hypothesized that patients with low levels of EVLW ( measured with the Picco® system ) need low level of PEEP to ameliorate their oxygenation ( measured with the PaO2/FiO2 ratio ) whereas patients with high levels of EVLW) need high levels of PEEP.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Acute Respiratory Distress Syndrome

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age\>18; * ARDS criteria. Exclusion Criteria: * severe pulmonary hypertension; * chronic right ventricular failure; * pulmonary embolism; * tricuspidian valvulopathy; * history of spontaneous pneumothorax; * severe emphysema; * bronchomalacia; * recent pulmonary surgery; * BMI\>40; * Interstitial pulmonary fibrosis; * End of life; * Chronic neuromyopathie; * Recent neurosurgery or intracranian hypertension; * Pregnancy.

Outcomes

Primary Outcomes

Estimate the Lung Water Extra-Vascular as predictive marker of the answer (Variation of needs in oxygen) to the ventilatory strategy: the low level, and high level of pressure positive expiratory, in the SDRA