Electrical Impedance Tomography Monitoring and Invasive Mechanical Ventilation During Pronation in Acute Respiratory Distress Syndrome.

Study Overview
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Brief Summary
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Acute respiratory distress syndrome is an acute form of lung injury. The most commonly used classification criteria for this syndrome are Berlin's Criteria. The actual literature underlines the advantages of prone position in mild or severe forms of ARDS in association with invasive mechanical ventilation. The hypothesis of this study is to investigate the effective ventilation and perfusion modifications during pronation assessed with clinical parameters and with the aid of the electrical impedance tomography.

Official Title
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Electrical Impedance Tomography Monitoring and Invasive Mechanical Ventilation During Pronation in Acute Respiratory Distress Syndrome.

Conditions
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ARDS, Human

Intervention / Treatment
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* Device: Electrical impedance tomography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: mild or severe ARDS according to Berlin's Criteria recruitment maximum 72 hours from the diagnosis of ARDS Exclusion Criteria: other non-ARDS respiratory system pathologies hemodynamic instability (mean arterial pressure < 60 mmHg) pneumothorax endocranial hypertension skin lesions or burns presence of pacemaker or implantable defibrillator pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ARDS<br>Patients with mild or severe ARDS necessitating of prone position during mechanical ventilation | Device: Electrical impedance tomography<br>* Every patient is monitored with electrical impedance tomograpy before, during and after prone position.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pronation and Regions of Interest increase in percentage | Demonstrate that pronation, without any recruitment maneuver, augments the dorsal regions of interest of 5%. | 1 hour after supination | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PaO2/FiO2 ratio and ventral/dorsal Regions of Interest ratio | Obtain a statistical significant increase of PaO2/FiO2 ratio, with a consensual decrease of the ventral/dorsal Region of Interest ratio. It'a a measure of the difference between two ratios. | 1 hour after supination | 
| Homogeneity of the ventral and dorsal regions from 0 to 1 | Verify in which of the 4 measurements (T0-T1-T2-T3) the ventral/dorsal Region of Interest ratio is closer to 1, which means a complete homogeneity of the ventral and dorsal regions. | 1 hour after supination | 
| Region of Interest ratio and days of mechanical ventilation. | Understand if there is an association between ROI ratio and the days of mechanical ventilation. | 30 days after pronation | 
| Region of Interest ratio and length of stay in intensive care unit | Understand if there is an association between ROI ratio and the length of stay in intensive care unit. | 30 days after pronation |