Change in the Phase III Slope of the Volumetric Capnography by Prone Positioning in Acute Respiratory Distress Syndrome

Istanbul University - Cerrahpasa60 enrolled

Overview

This study evaluates the effects of prone positioning on homogenization of ventilation.

After initiation of mechanical ventilation and assessing the eligibility of the patient, informed consent will be taken from the closest kin. If eligible, following steps will be performed which are part of standard ARDS patient care. 1. Low-flow Pressure Volume curve and assessment of airway opening pressure 2. Calculation of recruitment to inflation ratio 3. Optimizing Positive End-Expiratory Pressure Afterwards, phase III slope of the patient will be recorded at four timepoints: Supine 1 (immediately before turning to prone position) Prone 1 (immediately after prone position) Prone 2 (at the end of the 16-24 hour prone cycle) Supine 2 (immediately after turning to supine position)

Study Type

OBSERVATIONAL

Enrollment

Conditions

Acute Respiratory Distress Syndrome Ventilation Perfusion Mismatch Respiratory Failure

Interventions

Prone PositioningPROCEDURE

Patients will be turned to prone position and they will be left in prone position for a duration of at least 16 hours to a maximum of 24 hours. This duration is recommended by the ARDS guidelines.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ARDS criteria met * intubated and mechanically ventilated as a result of respiratory failure * PaO2/FiO2 \<200 Exclusion Criteria: * age older than 18 * Chronic pulmonary disease, pneumothoraces, intraabdominal hypertension (\> 12 mmHg), pregnancy, not expected to survive \>24 hours, hemodynamic instability

Locations (1)

Hamidiye Etfal Hospital

Istanbul, Turkey (Türkiye)

RECRUITING

Outcomes

Primary Outcomes

Change from baseline in phase iii slope of the volumetric capnograph

phase iii slope is associated with the ventilation homogeneity

Time frame: 16 to 24 hours (according to time spent in the prone position)

correlation of the phase iii slope with the recruitment to inflation ratio

recruitment to inflation ratio is a simple bedside tool that indicates a higher possible recruitable lung with higher applied Positive End-Expiratory Pressure

Time frame: 16 to 24 hours (according to time spent in the prone position)

Secondary Outcomes

correlation of the phase iii slope with the Partial pressure of the arterial oxygen/ Fraction of inspired O2 concentration (PaO2/FiO2) ratio

PaO2/FiO2 is markedly reduced in ARDS patients as a consequence of aeration loss

Time frame: 16 to 24 hours (according to time spent in the prone position)

Central Contacts

Olcay Dilken, MD

CONTACT

+905547378709 olcaydilken@gmail.com

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.