Characterization of the microVAScular Dysfunction in Covid-19 ARDS

Assistance Publique - Hôpitaux de Paris40 enrolled

Overview

The primary endpoint of this research is to establish that the alveolar dead space is significantly higher in patients with COVID-19 ARDS, compared to patients with non-COVID-19 ARDS. Secondarily, the investigators want to establish the prognostic value of the alveolar-dead space (measured iteratively) in patients with COVID-19 and non-COVID-19 ARDS, to establish the respective influences of the biological parameters of endothelial damage, of the biological parameters of coagulopathy, of the parameters set on the artificial ventilator on the value of the alveolar dead space; in ARDS patients with COVID-19 and non-COVID-19 ARDS, to establish the prognostic value of the laboratory parameters of endothelial damage and coagulopathy in patients with COVID-19 and non-COVID-19 ARDS.

Endothelial damage and coagulation activation at the lung microvascular level may play an important role in the physiopathology of the COVID-19 ARDS. The project aims to prospectively investigate both bedside pulmonary physiological markers and biological markers of coagulopathy and endothelial dysfunction in COVID-19 and non-COVID-19 ARDS patients.

Study Type

OBSERVATIONAL

Enrollment

Conditions

ARDS, Human COVID-19 Acute Respiratory Distress Syndrome

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age\> 18 years old * Invasive mechanical ventilation in place for less than 48 hours * Severe or moderate ARDS (defined according to the Berlin classification) * Virological confirmation by PCR of SARS-CoV-2 infection (ARDS COVID-19) * Lack of virological confirmation by PCR of SARS-CoV-2 infection (ARDS not linked to COVID-19) * Patient information Exclusion Criteria: * Massive pulmonary embolism * Chronic respiratory failure under long-term oxygen therapy * Dying patient

Outcomes

Primary Outcomes

Prognostic value of alveolar dead space

Recording the exhaled CO2 curve (side-stream capnography method) and volume curve, as determined by the mechanical ventilator, and computing the signals with the arterial CO2 partial pressure, reflecting the partial pressure of CO2 in the alveoli participating in gas exchanges), determined on arterial blood gas (ABG) sampling.

Time frame: Up to 28 days

Secondary Outcomes

Prognostic value of the alveolar dead space (measured iteratively)

To establish the link between alveolar dead-space values and Day 20 mortality

Time frame: 20 days

Prognostic value of the alveolar dead space (measured iteratively)

To establish the link between alveolar dead-space values and Day 20 mortality and Day-28 invasive ventilator-free days.

Time frame: 28 days

Level of circulating endothelial cells