Assessment of Lung Mechanics in COVID-19 Acute Respiratory Distress Syndrome

Study Overview
=================
Brief Summary
-----------------
This study is meant to assess the lung mechanics in SARS-CoV-2 induced acute respiratory failure. A precise characterisation of lung mechanics and heart-lung-interactions might allow a better understanding of SARS-CoV-2 induced acute respiratory failure and thus lead to better mechanical ventilation strategies. This monocentric, observational study of critically ill COVID-19 patients in the ICU, will employ impedance tomography, right-heart catheterization, oesophageal pressure measurements, indirect calorimetry as well as classic mechanical ventilation parameters to characterise the mechanical characteristics of the lung as well as the heart-lung interactions in SARS-CoV-2 induced acute respiratory failure.

Official Title
-----------------
Assessment of Lung Mechanics in SARS-CoV-2/ COVID-19 Acute Respiratory Distress Syndrome: A Holistic, Longitudinal Analysis of the Lung-heart-ventilator Interaction

Conditions
-----------------
Covid19, ARDS

Intervention / Treatment
-----------------
* Diagnostic Test: Assessment of lung mechanics and heart-lung interactions


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: SARS-CoV-2 infection Moderate to Severe ARDS after Berlin Classification at PEEP 5 Admission to the Institute of Intensive Care of the University Hospital Zurich Invasive Mechanical Ventilation Signed Study Informed Consent or emergency procedure according to article 30 HFG Exclusion Criteria: Pregnant or breast feeding patients Age <18 years Presumed rejection of the study intervention

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Assessment of lung mechanics and heart-lung interactions|Impedance tomography, right-heart catheterization, oesophageal pressure measurements, indirect calorimetry and classic mechanical ventilation parameters|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time dependent compliance change | Compliance change over the length of mechanical ventilation | Mixed Model Assessment of compliance over time until extubation (measurements every 2 days up to 90 days) | 
| PEEP and time dependent change in dead space | Change in Dead Space over the length of mechanical ventilation | Mixed Model Assessment of Dead Space over time until extubation (measurements every 2 days up to 90 days) | 
| PEEP and time dependent change in shunt fraction | Change in shunt fraction over the length of mechanical ventilation | Mixed Model Assessment of shunt fraction over time until extubation (measurements every 2 days up to 90 days) | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
lung mechanics, heart-lung interaction