The aim of this study is to characterize ventilation/perfusion (V/Q) matching in adult patients receiving peripheral VA ECMO support while on mechanical ventilation, and to evaluate the impact of PEEP titration guided by Electrical Impedance Tomography (EIT) and esophageal pressure measurements on lung mechanics and V/Q optimization.
The investigators hypothesize that an individualized PEEP titration guided by esophageal pressure measurements and Electrical Impedance Tomography can reduce lung overdistention, enhance lung recruitment, and improve V/Q matching by optimizing regional ventilation and perfusion also in VA ECMO. Our objectives are: 1. To describe V/Q matching in patients undergoing mechanical ventilation during peripheral VA ECMO support. 2. To explore the impact of PEEP titration based on esophageal pressure and EIT in terms of lung mechanics and V/Q matching.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
10
Measurement of lung perfusion (via EIT) and transpulmonary pressure (via esophageal manometry) during decremental PEEP trial
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
V/Q match
Primary outcome measure: Reduction in shunt fraction (expressed in %) Secondary outcome measure: Reduction in dead space (expressed as volume) Respiratory mechanics will be recorded before and after best PEEP. Ventilation (L/min)/Perfusion (L/min) \[V/Q\] ratio comparing baseline with best PEEP (after PEEP optimization trial).
Time frame: 1 hour
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.