The aim of the COMIX-R study is to assess the short term physiological effects of 3 ventilation strategies for adult patients with ARDS admitted to intensive care unit
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
20
Patients are ventilated in randomised order with three different ventilation strategies: volume assist control (constant flow), Dual Mode or Airway Pressure Released Ventilation
University hospital
Angers, France
change of PaO2 (mmHg)
Arterial partial pressure of dioxygen Of note: As it is a physiological study, all the primary and secondary outcomes will be analyzed with the same importance.
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Respiratory rate variability
variability of rate (per minute)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-expiratory and inspiratory transpulmonary pressure
calculated with the esophageal pressure (cm H20)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-ventilation distribution in the lungs
Electrical impedance tomography (EIT) assess distribution of tidal volume and of end-expiratory lung volume (EELV) (delta Z, IU)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-other arterial parameters of hematosis
pH, PaO2, PaCo2 (mmHg)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Work of breathing (WOB)
calculated with esophageal pressure (Kg/m)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Pressure time product (PTP)
-Pressure time product (PTP) calculated with esophageal pressure (cmH2O.s.min-1)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
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-P0.1
pressure measured during the first 100 ms after an occlusion (cm H20)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-PEEPi
intrinsic positive end-expiratory pressure (cm H20)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
MAP
mean arterial pressure
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
HR
heart rate (beats per minute)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Respiratory comfort
visual analogic scale
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Patient-ventilator asynchronies
numbers of asynchronies analyzed on screen
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Tidal volume variability
variability of Tidal volume (mL)
Time frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes