Gas Exchange Derangement Physiopathology in Critically Ill Patients With COVID-19

Policlinico Hospital14 enrolled

Overview

The study was designed to understand the pathophysiology of gas exchange derangement in critically ill patients with COVID-19. Specifically we will evaluate the effect of 3 different levels of positive end-expiratory pressure (PEEP) and two different levels of inspiratory oxygen fraction (FiO2) on gas exchange by analyzing shunt and dead space. Furthermore, complete respiratory mechanics and distribution of ventilation and perfusion by electrical impedance tomography will be assessed at each level of PEEP.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Respiratory Failure

Interventions

PEEP trial - Electrical Impedance TomographyPROCEDURE

Three different levels of PEEP and two different levels of FiO2 will be tested without changing anything else in the baseline patient ventilation

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients admitted in intensive care unit for COVID-19 related Acute Respiratory Distress Syndrome (ARDS) requiring invasive mechanical ventilation Exclusion Criteria: * Pregnancy * Hemodynamic instability (80-90 mmHg increase or 30-40 mmHg decrease systolic arterial pressure compared to baseline value or need of vasopressors to maintain systolic blood pressure higher than 85 mmHg or electrocardiogram evidence of ischemia/arrhythmias) * Presence of pneumothorax and/or pneumomediastinum * Contraindications to Electrical Impedance Tomography (pacemaker, implantable cardioverter defibrillator, thoracic drainages)

Locations (1)

Ospedale Maggiore Policlinico

Milan, MI, Italy