Prono Position and Mechanical Power

Study Overview
=================
Brief Summary
-----------------
The primary objective of the study is to compare the mechanical power applied to the respiratory system in patient with acute respiratory distress syndrome in supine positioning and after the implementation of prone positioning while mantaining the same ventilatory setting. The secondary objetive of the study is to compare the mechanical power applied to the respiratory system in patient with acute respiratory distress syndrome in supine positioning and after the implementation of prone positioning and adjusting an individualized ventilatory setting.

Detailed Description
-----------------
Data of mechanical power will be collected prospectively in three different times: In supine positioning (T0). After 15 minutes of having implemented prone positioning while maintaining the same ventilatory settings that in supine (T1). In prone positioning after 15 min of having adjusted an individualized ventilatory setting (T2). Besides, the investigators will take an arterial blood sample in T0 and T2 to calculate changes in oxygenation status and ventilatory ratio. In case that esophageal manometry is available, the investigators will collect data regarding to transpulmonary and esophageal pressure in order to calculate the mechanical power applied to the lung parenchyma.

Official Title
-----------------
Influence of the Prone Position on Mechanical Power Applied to Respiratory System: Multi-centric Descriptive Study

Conditions
-----------------
Acute Respiratory Distress Syndrome

Intervention / Treatment
-----------------
* Other: Prone position


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients aged older than 18 years old under invasive mechanical ventilation with diagnostic criteria of acute respiratory distress syndrome acording to berlin definition and neccesity of prone positioning. Exclusion Criteria: Need to interrump prone positioning maneuver. Inability to collect data for any reason.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 100 Years

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

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

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

Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Prone position|The patients will be put in prone position while receiving invasive mechanical ventilation and the investigators will monitor changes in mechanical power applied to the respiratory system and compare with supine position|

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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mechanical power of the respiratory system measured in supine compared with prone position while maintaining the same ventilatory setting | Mechanical power measured in Joules/min | 1) Supine position; 2) Prone position, after 15 min | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mechanical power of the respiratory system measured in supine compared with prone position after adjusting the ventilatory setting | Mechanical power measured in Joules/min | 1) Supine position; 2) Prone position, after 15 min of adjusting ventilatory setting. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
ventilation, artificial, respiratory distress syndrome, adult, prone position, monitoring, physiologic