Electrical Impedance Tomography Monitoring and Invasive Mechanical Ventilation During Pronation in Acute Respiratory Distress Syndrome.

Azienda Sanitaria-Universitaria Integrata di Udine15 enrolled

Overview

Acute respiratory distress syndrome is an acute form of lung injury. The most commonly used classification criteria for this syndrome are Berlin's Criteria. The actual literature underlines the advantages of prone position in mild or severe forms of ARDS in association with invasive mechanical ventilation. The hypothesis of this study is to investigate the effective ventilation and perfusion modifications during pronation assessed with clinical parameters and with the aid of the electrical impedance tomography.

Study Type

OBSERVATIONAL

Enrollment

Conditions

ARDS, Human

Interventions

Electrical impedance tomographyDEVICE

Every patient is monitored with electrical impedance tomograpy before, during and after prone position.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * mild or severe ARDS according to Berlin's Criteria * recruitment maximum 72 hours from the diagnosis of ARDS Exclusion Criteria: * other non-ARDS respiratory system pathologies * hemodynamic instability (mean arterial pressure \< 60 mmHg) * pneumothorax * endocranial hypertension * skin lesions or burns * presence of pacemaker or implantable defibrillator * pregnancy

Outcomes

Primary Outcomes

Pronation and Regions of Interest increase in percentage

Demonstrate that pronation, without any recruitment maneuver, augments the dorsal regions of interest of 5%.

Time frame: 1 hour after supination

Secondary Outcomes

PaO2/FiO2 ratio and ventral/dorsal Regions of Interest ratio

Obtain a statistical significant increase of PaO2/FiO2 ratio, with a consensual decrease of the ventral/dorsal Region of Interest ratio. It'a a measure of the difference between two ratios.

Time frame: 1 hour after supination

Homogeneity of the ventral and dorsal regions from 0 to 1

Verify in which of the 4 measurements (T0-T1-T2-T3) the ventral/dorsal Region of Interest ratio is closer to 1, which means a complete homogeneity of the ventral and dorsal regions.

Time frame: 1 hour after supination

Region of Interest ratio and days of mechanical ventilation.

Understand if there is an association between ROI ratio and the days of mechanical ventilation.

Time frame: 30 days after pronation

Region of Interest ratio and length of stay in intensive care unit

Understand if there is an association between ROI ratio and the length of stay in intensive care unit.

Time frame: 30 days after pronation

Electrical Impedance Tomography Monitoring and Invasive Mechanical Ventilation During Pronation in Acute Respiratory Distress Syndrome.

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes