Trunk Inclination, Positive End-expiratory Pressure, and Lung Recruitability
Impact of Trunk Inclination on Lung Mechanics According to PEEP and Reruitability
Zhongda Hospital
40 participants
Mar 20, 2026
OBSERVATIONAL
Conditions
Summary
This multicenter, physiological, observational study hypothesizes that in moderate to severe ARDS, trunk inclination unloads the chest wall, but its impact on lung mechanics depends on PEEP levels and lung recruitability.
Eligibility
Inclusion Criteria2
- Intubated moderate and severe ARDS according to the Berlin definition (PaO2/FiO2 ratio \<= 200 mmHg)
- Under continuous sedation with or without paralysis
Exclusion Criteria9
- Age \<18 years
- Bronchopleural fistula
- Pure COPD exacerbation
- Contraindication to EIT monitoring (e.g. burns, pacemaker, thoracic wounds limiting electrode belt placement)
- Hemodynamic instability (Systolic BP \< 75 mmHg or MAP \< 60 mmHg despite vasopressors and/or heart rate \< 55 bpm)
- Contraindications to mobilization (e.g., intracranial hypertension, spinal cord injury)
- Intra-abdominal hypotension (IAP≥12mmHg)
- Pregnancy
- Attending physician deems the transient application of high airway pressures to be unsafe
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Interventions
Specific lung recruitment maneuvers will be performed to measure the potential for lung recruitment. Followed by a decremental PEEP steps to determine lung mechanics at different PEEP levels. These process will be repeated when patients change to another position. Electrical impedance tomography signals, synchronized signals of airway pressure and flow, esophageal pressure will be recorded continuously.
Locations(3)
View Full Details on ClinicalTrials.gov
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NCT07504731