RecruitingNot ApplicableNCT07248995

Contribution of Transthoracic and Transcranial Ultrasonography to the Titration of PEEP in Patients With ARDS and ABI

The Contribution of the Combination of Transthoracic and Transcranial Ultrasonography to the Titration of Positive End-expiratory Pressure in Patients With Acute Respiratory Distress Syndrome and Acute Brain Injury

Sponsor

Theodoros Schizodimos

Enrollment

30 participants

Start Date

Dec 1, 2025

Study Type

INTERVENTIONAL

Conditions

Acute Respiratory Distress Syndrome (ARDS)

Summary

The present study will investigate whether the combined use of lung and brain ultrasonography is useful in selecting the optimal positive end-expiratory pressure in mechanically ventilated critically ill patients with acute respiratory distress syndrome and acute brain injury, aiming at an individualized, brain-protective ventilation strategy.

Eligibility

Min Age: 18 Years

Inclusion Criteria3

Age ≥ 18 years
Severe acute brain injury (e.g., traumatic brain injury, subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke)
Development of ARDS (according to Berlin criteria) within the first 10 days of ICU admission

Exclusion Criteria8

Severe chronic brain diseases
Brain tumor or central nervous system (CNS) infection
Severe chronic pulmonary or cardiovascular disease
Severe coagulopathy
Undergoing decompressive craniectomy
Lack of invasive neuromonitoring
Withdrawal of life-sustaining treatment
Poor acoustic window in ultrasound

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Interventions

PROCEDUREStepwise Positive End-Expiratory Pressure (PEEP) Increase Protocol

The intervention includes a stepwise increase in PEEP level from 5 to 8, 12 and 16 centimeter of water (cmH2O). After each PEEP level change, lung ultrasound and transcranial doppler will be performed, and the values of intracranial pressure (ICP) and brain oxygen partial pressure (PO2), as well as the mechanical ventilation parameters, will be recorded. Arterial blood gases will be taken 20 minutes later.