RecruitingNCT06594601

PEEP Titration and Lung Recruitment Potential Assessed by 3D EIT

PEEP Titration and Lung Recruitment Potential Assessment by 3D EIT in ARDS Patients

Sponsor

Peking Union Medical College Hospital

Enrollment

50 participants

Start Date

Jan 1, 2024

Study Type

OBSERVATIONAL

Conditions

Respiratory Failure ARDS

Summary

In a population of ARDS patients, we explore the influence of different PEEP levels on regional ventilation distribution, ventilation homogeneity, and the center of ventilation, optimal PEEP and lung recruitment potential as well as the extent of lung collapse and overdistension as detected by 3D-EIT.

Eligibility

Min Age: 18 Years

Inclusion Criteria3

patients on mechanical ventilation.
Diagnosis of ARDS was based on the Berlin definition
lung recruitment potential assessment and PEEP titration was proper for the ARDS patients determined by the attending doctor

Exclusion Criteria6

Under 18 years of age.
Pregnant women;
Ribcage malformation
Any contraindication to the use of EIT (e.g. automatic implantable cardioverter defibrillator, and implantable pumps).
Hemodynamic instability, unable to tolerate high PEEP;
High-risk individuals with pneumothorax, mediastinal emphysema, etc.

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Interventions

PROCEDURElung recruitment potential assessed by 3D EIT

Patients were ventilated based on the ARDS-Net suggestions. The patients were kept at supine position. The lung recruitment potential assessed by 3D EIT was as follows: 1. All patients were under pressure control mode (driving pressure 12-15 cmH2O with a tidal volume of 6-8 ml/kg predicted body weight, respiration rate12-15 bpm). 2. PEEP was switched to a zero end-expiratory pressure (ZEEP) for 10 min, and FiO2 was titrated to obtain peripheral oxygen saturation (SpO2 ) \> 90%. 3. PEEP was stepwise increase from 0 to 15 cmH2O PEEP in steps of 5cm H2O every 3min.And 3D EIT was used to assess lung recruitment potential.

PROCEDUREPEEP titration by 3D eit

Patients were ventilated based on the ARDS-Net suggestions. The patients were kept at supine position. The PEEP titriatino by 3D EIT fwas as follows: 1. All patients were under pressure control mode (driving pressure 12-15 cmH2O with a tidal volume of 6-8 ml/kg predicted body weight, respiration rate12-15 bpm). 2. RM: PEEP was switched to a 21cmH2O for 2min, and FiO2 was titrated to obtain peripheral oxygen saturation (SpO2 ) ≥90%. 3. PEEP was stepwise decrease from 21 to 0 cmH2O PEEP in steps of 3cm H2O every 2min. 4. 3D EIT was used to monitor regional ventilation distribution during PEEP titration.