NCT03140579

Effect of PEEP on Lung Recruitment and Homogeneity Over Time in Moderate to Severe ARDS

Estimation of Long Term PEEP Effect on Lung Homogeneity and Recruitment Using APRV Ventilation:Measurement of End Expiratory Lung Volume With Nitrogen Wash-out/wash-in Technique and End Expiratory Lung Impedance With EIT at Different Times.

• Status: Withdrawn
• Phase: —
• Study type: Observational
• Enrollment: 0 (actual)
• Sponsor: Guy's and St Thomas' NHS Foundation Trust · Academic / Other
• Sex: All
• Age: 18 Years – 80 Years
• Healthy volunteers: Not accepted

Summary

This study evaluates the effect of airway pressure release ventilation (APRV) on lung homogeneity and recruitment in patients with moderate to severe acute respiratory distress syndrome (ARDS). It will do this by comparing the homogeneity of ventilation and recruitment prior to a patient being ventilated on APRV, and at 30, 60 and 120 minutes after starting APRV.

Detailed description

Ventilator-induced lung injury (VILI) is a well-recognised problem of ventilation in patients with ARDS, and is currently treated with lung-protective ventilation, which limits tidal volumes and airway pressures by applying higher levels of positive-end expiratory pressure (PEEP). However, it is not known whether higher levels of PEEP increases recruitment and homogeneity of ventilation within the lungs. APRV is a mode of inverse ventilation, where high levels of PEEP are maintained with brief releases of pressure, and has been proposed as an appropriate method of ventilation in patients with ARDS. This study will assess homogeneity of ventilation and recruitment in 15 patients before APRV is started, and 30, 60 and 120 mins after commencing APRV. It will do this using Electrical Impedance Tomography (EIT), nitrogen wash in/wash out technique, and lung strain.

Conditions

• ARDS
• Critical Illness
• Ventilator-Induced Lung Injury

Interventions

Type	Name	Description
OTHER	APRV	Airway pressure release ventilation is a method of inverse ventilation, where high levels of positive end expiratory pressure are maintained to optimise oxygenation with brief releases of pressure to allow ventilation and release carbon dioxide. It is an approved and frequently used method of ventilation.

Timeline

• Start date: 2018-06-01
• Primary completion: 2018-12-31
• Completion: 2018-12-31
• First posted: 2017-05-04
• Last updated: 2022-08-17

Locations

1 site across 1 country: United Kingdom