Expiratory or inspiratory transpulmonary pressures have been proposed to optimize ventilator settings in patients with ARDS. The aim of this study is to assess the feasibility and the physiological effects of a new method based on both expiratory and inspiratory transpulmonary pressures.
Expiratory or inspiratory transpulmonary pressures have been proposed to optimize ventilator settings in patients with ARDS. A positive expiratory transpulmonary pressure may be considered as a target to limt the risk of collapse in dependant lung regions. Some authors propose to titrate PEEP to target an inspiratory transpulmonary pressure of 20cmH20 to limit the risk of overdistension in non-dependant regions.The aim of this study is to assess the feasibility and the physiological effects of a new method based on both expiratory and inspiratory transpulmonary pressures.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
PEEP and Tidal Volume Titration According to Inspiratory and Expiratory Transpulmonary Pressures
Chu Angers
Angers, France
Ventilation strategy failure
Number of patients with failure criteria (barotrauma, hemodynamic failure, rescue therapy or acidemia)
Time frame: 48 hours
Short term physiologicals effects on hemodynamics
Cardiac index assed by Echocardiography (L/min/m\^2)
Time frame: 45 minutes
All-cause mortality at day 28
All-cause mortality
Time frame: 28 days
Ventilator-free days at day 28
Number of alive ventilator free days
Time frame: 28 days
Short term physiologicals effects on respiratory mechanics
recruited lung volume (mL)
Time frame: 45 minutes
Short term physiologicals effects on gas exchange
PaO2/FiO2 ratio (mmHg)
Time frame: 45 minutes
Short term physiologicals effects on gas exchange
VD/VT
Time frame: 45 minutes
Short term physiologicals effects on gas exchange
PaCO2 (mmHg)
Time frame: 45 minutes
Short term physiologicals effects on respiratory mechanics
distribution of ventilation assed by electrical impedance tomography (COV, %)
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Time frame: 45 minutes