RecruitingNot ApplicableNCT06936618

EIT-Guided Ventilator Settings in AHRF

Using Electrical Impedance Tomography-Guided Ventilator Settings to Reduce Mechanical Power in Acute Hypoxemic Respiratory Failure : An Exploratory Study

Sponsor

Mahidol University

Enrollment

17 participants

Start Date

Dec 17, 2024

Study Type

INTERVENTIONAL

Conditions

Acute Respiratory Distress Syndrome (ARDS)Acute Hypoxemic Respiratory Failure Mechanical Power

Summary

This exploratory study aims to investigate the effect of Electrical Impedance Tomography (EIT)-guided ventilator settings on mechanical power in patients with acute hypoxemic respiratory failure (AHRF), including both ARDS and non-ARDS conditions. Mechanical power, a key factor associated with ventilator-induced lung injury (VILI), will be measured before and after EIT-guided PEEP titration. The study will evaluate feasibility and changes in lung mechanics, gas exchange, and EIT parameters. A total of 17 patients requiring invasive mechanical ventilation will be enrolled at Siriraj Hospital, Mahidol University.

Eligibility

Min Age: 18 Years

Inclusion Criteria5

Age ≥ 18 years
Diagnosed with acute hypoxemic respiratory failure within 48 hours
Expected to require invasive mechanical ventilation ≥ 48 hours
On mechanical ventilation within 24 hours
Deep sedation and neuromuscular blockade

Exclusion Criteria17

Pregnancy
Body mass index (BMI) \> 40 kg/m2
Contraindications to using electrical impedance tomography, including
Presence of a pacemaker or automatic implantable cardioverter-defibrillator (AICD)
Inability to place the belt due to presence of surgical wounds dressing, thoracic or spinal cord trauma, recent thoracic surgery, etc.
High risk for PEEP titration
Hemodynamic instability defined as mean arterial pressure \< 65 mmHg despite optimization of fluid status and/or use of vasopressors
Unstable cardiac arrhythmias
Presence of lung bullae greater than 2 cm in diameter, identified on chest X-ray
Presence of pneumothorax or pneumomediastinum
Right-sided heart failure or severe pulmonary hypertension
Neurologic conditions associated with a risk of intracranial hypertension
Use of extracorporeal membrane oxygenation (ECMO)
Severe chronic respiratory disease, defined as follows: requiring home oxygen therapy, or previous lung function showing (FEV1 less than 20 ml/kg PBW, or FEV1/FVC less than 50% predicted value), or chronic hypercapnia (PaCO2 greater than 45 mmHg) and/or chronic hypoxemia (PaO2 less than 55 mmHg) on FIO2 = 0.21, or radiographic x-ray evidence of any chronic over-inflation or chronic interstitial infiltration, or chronic restrictive, obstructive, neuromuscular, chest wall or pulmonary vascular disease resulting in severe exercise restriction (unable to climb stairs or perform household duties, secondary polycythemia, severe pulmonary hypertension with mean pulmonary arterial pressure greater than 40 mmHg)
Decision to withhold life-sustaining treatment or palliative care.
Moribund status with an expected survival of less than 24 hours.
Refusal to provide informed consent