RecruitingNot ApplicableNCT06990477

Effect of EIT-guided PEEP in ARDS Patients With Higher Recruitability

Effect of EIT-guided PEEP On Clinical Outcomes in ARDS Patients With Higher Recuritability: a Pilot Randomized Controlled Trial

Sponsor

Southeast University, China

Enrollment

264 participants

Start Date

Jan 28, 2026

Study Type

INTERVENTIONAL

Conditions

ARDS (Acute Respiratory Distress Syndrome)

Summary

Acute respiratory syndrome distress (ARDS) is a clinical common syndrome with high mortality. Mechanical ventilation (MV) is the cornerstone of management of ARDS but can lead to ventilator-induced lung injury. Positive end-expiratory pressure (PEEP), as one of main component of MV, has been widely used in the clinical practice. However, the PEEP selection is still a difficult problem for moderate to severe ARDS patients. EIT, an imaging tool evaluating the regional ventilation distribution at the bedside, can achieve the individual PEEP selection for all mechanically ventilated patients. Our previous study found that moderate to severe ARDS patients with higher recruitability could benefit from EIT-guided PEEP. This article compared the effect of PEEP titrated guided by EIT with fraction of inspired oxygen (FiO2)-PEEP table on the clinical outcomes in patients with higher recruitability.

Eligibility

Min Age: 19 YearsMax Age: 85 Years

Inclusion Criteria4

Age≥18 years
Moderate-to-severe ARDS, defined by the ARDS Definition Task Force in the Berlin definition (partial pressure of arterial oxygen \[PaO2\]:FiO2 ratio ≤200 mmHg with a PEEP ≥5 cmH2O)
RI ratio \> 0.5 measured for clinical reasons in the previous 24 hours
Diagnosis of ARDS less than 72 hours

Exclusion Criteria13

Expected to be mechanically ventilated for less than 48 hours
Severe chronic respiratory diseases requiring long-term home oxygen therapy or noninvasive MV
Undrained pneumothorax or subcutaneous emphysema
Undergoing extracorporeal membrane oxygenation (ECMO) before enrollment
Contraindication to the use of EIT (pacemaker, automatic implantable cardioverter defibrillator, and implantable pumps)
Severe neuromuscular disease
Hemodynamic instability
Contraindications to hypercapnia, such as intracranial hypertension or acute coronary syndrome
Severe other organs dysfunction with a low expected survival (7 days) or palliative care
Solid organ or hematologic tumors with the expected survival time less than 30 days
Participating in other clinical trials within 30 days
Pregnancy
Refusal to sign the informed consent

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Interventions

DEVICEEIT-guided PEEP

PEEP titrated by EIT will be performed with a decremental trial at the enrollment. Right after completing RM, PEEP will be set to 20cmH2O and then reduced in steps of 2cmH2O from 20 to 6 every 2min.