RecruitingNot ApplicableNCT06790875

Effects of Low Tidal Volume and Airway Pressure Release Ventilation on Lung Tissue Mechanics in ARDS Patients Under Mechanical Ventilation: A Prospective Randomized Crossover Study


Sponsor

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Enrollment

15 participants

Start Date

Nov 20, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to learn how low tidal volume ventilation (LTV) and airway pressure release ventilation (APRV) affect lung tissue mechanics in adults with ARDS. The main questions it aims to answer are: Does LTV or APRV improve lung tissue mechanics in patients with ARDS under mechanical ventilation? Researchers will compare LTV and APRV to see which ventilation mode works better for improving lung mechanics and patient safety.


Eligibility

Min Age: 18 YearsMax Age: 80 Years

Inclusion Criteria5

  • Meets the diagnostic criteria of the 2023 Global New Definition of ARDS.
  • Age: 18-80 years.
  • PaO2/FiO2 ≤ 200.
  • Within 12 hours of invasive mechanical ventilation treatment.
  • Obtain consent from the patient or their family members to participate in the study, and sign the informed consent form.

Exclusion Criteria7

  • Age \< 18 years or \> 80 years.
  • Uncorrected shock of any type.
  • Chronic obstructive pulmonary disease (COPD), pulmonary embolism, right heart failure, pulmonary hypertension, or severe arrhythmia.
  • Contraindications for using Electrical Impedance Tomography (EIT) (extensive chest skin damage, infection, pacemaker implantation, implanted automatic defibrillator, etc.), pneumothorax, mediastinal emphysema, or large pleural effusion.
  • Pregnant or breastfeeding women.
  • Patients planned for ECMO treatment.
  • Patients currently participating in or previously enrolled in other clinical studies.

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Interventions

DEVICEAirway Pressure Release Ventilation (APRV)

In this arm, participants will receive airway pressure release ventilation (APRV), a form of pressure-controlled mechanical ventilation. The high pressure (Phigh) is set based on the plateau pressure of the LTV mode, with a low pressure (Plow) set at 0 cmH₂O. The high pressure time (Thigh) will be set to 4-6 seconds to maintain alveolar recruitment, while the low pressure time (Tlow) will be set to 0.2-0.6 seconds to optimize expiratory flow. This arm aims to evaluate the effects of APRV on lung tissue mechanics, oxygenation, and overall respiratory function in ARDS patients.


Locations(1)

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, China

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NCT06790875


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