A Comparison of Optimal PEEP Determination Guided by EIT and Conventional Protective Ventilation Tool in ARDS Patients
Condition: ARDS; Acute Respiratory Distress Syndrome
MeSH terms: Respiratory Distress Syndrome; Respiratory Distress Syndrome, Newborn; Acute Lung Injury; Syndrome
Study type: Interventional

Summary: 
      The study of positive end-expiratory pressure(PEEP) in the setting mode has not yet been
      conclusive. there are several ways to choose the best positive end-expiratory pressure(PEEP)
      mode for ARDS patients. In this study ,the investigators selected two best positive
      end-expiratory pressure(PEEP) assessment methods to compare:

      First is using the conventional postive ventilator to choose positive end-expiratory
      pressure(PEEP) and the new non-invasive electrical impedance tomography(EIT) guided method
      and evaluation the treatment outcome in moderate and severe acute respiratory distress
      syndrome patients by using pressure-volume curve guided and electrical impedance tomography
      guided positive end-expiratory pressure setting. In this project, we utilize a newly
      available non-invasive method- electric impedance tomography (EIT) and Protective Ventilation
      to determine the optimal PEEP on ARDS patients required invasive mechanical ventilator
      support at a medical center medical ICU (MICU) and cardiovascular ICU (CVICU)- the Far
      Eastern memorial hospital, Taiwan.
    

Detailed description: 
      Acute respiratory distress syndrome (ARDS)，over the years in the treatment policy has been
      confirmed that: with low tidal volume to achieve lung protection strategy and high positive
      end-expiratory pressure (PEEP), both can effectively reduce the mortality rate. And increase
      PEEP，the alveolar pressure is greater than the atmospheric pressure when exhaled，So that can
      be effective expansion of the lungs to avoid spitting at the end of the alveolar collapse.

      The study of PEEP in the setting mode has not yet been conclusive. Currently in the clinical
      situation，there are several ways to choose the best PEEP mode for ARDS patients. In this
      study the investigators selected two best PEEP assessment methods to compare:

      First is using the conventional postive ventilator to choose optimal and the new non-invasive
      electrical impedance tomography guided method and evaluation the treatment outcome in
      moderate and severe acute respiratory distress syndrome patients by using pressure-volume
      curve guided and electrical impedance tomography guided positive end-expiratory pressure
      setting. In this project, the investigators utilize a newly available non-invasive method-
      electric impedance tomography (EIT) and Protective Ventilation to determine the optimal PEEP
      on ARDS patients required invasive mechanical ventilator support in ICU at the Far Eastern
      memorial hospital, Taiwan.
    

Intervention name(s): Ventiltor P/V Loop; Electrical Impedance Tomography
Intervention type(s): Device; Device
Intervention description(s): determine the Optimal PEEP and keep 48hr on ARDS patients; determine Optimal PEEP and keep 48hr on ARDS patients
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Moderate to severe ARDS patient on mechanical ventilation from ER or word transfer ICU.(P/F≦200+PEEP≧ 5cmH20)
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: ARDS; Acute Respiratory Distress Syndrome; PEEP; pressure-volume loop; Positive End-Expiratory Pressure; hysteresis