Clinical trial NCT05816928: Ventilation-Perfusion Matching in Early-stage Prone Position Ventilation
Official title: Ventilation-Perfusion Matching in Early-stage Prone Position Ventilation: A Comparison Between COVID-19 ARDS and ARDS From Other Etiologies
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Acute Respiratory Distress Syndrome
Keywords: Acute Respiratory Distress Syndrome
ICU
COVID19
Electrical impedance tomography
Lead sponsor: Peking Union Medical College Hospital
Sponsor class: OTHER
First posted: 2023-04-18
Enrollment: 29
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The study population includes COVID19-associated ARDS patients and ARDS patients of other etiologies in the intensive care unit.

Brief summary: Prone positioning has been widely used in critical care medicine to improve oxygenation in patients with acute respiratory distress syndrome (ARDS). This study aimed to compare the effect of pronation on lung ventilation-perfusion matching between COVID19-associated acute respiratory distress syndrome (CARDS) and ARDS from other etiologies (non-CARDS) using electrical impedance tomography (EIT).

Detailed description: In this prospective study, both COVID19-associated ARDS (CARDS) patients and patients with ARDS from other etiologies (non-CARDS) were enrolled. Electrical impedance tomography (EIT) was used to evaluate the changes in ventilation and perfusion between supine and prone positions. Baseline values of the area of DeadSpace, shunt, ventilation-perfusion matching (VQmatch) were identified at the time of enrollment. Within the defined VQmatch region, the global inhomogeneity index (VQmatch-GI) was calculated to assess the degree of uniformity within the region. Prone position was applied immediately after the baseline data were collected. After 2 hours of proning, another EIT examination was conducted. Parameters such as DeadSpace, shunt, VQmatch, and other common measurements before and after pronation were taken and compared to evaluate the effect of prone positioning on CARDS and non-CARDS patients.

Eligibility criteria: Inclusion Criteria:

* Above the age of 18
* Diagnosed with ARDS based on the Berlin Definition of ARDS
* Under mechanical ventilation

Exclusion Criteria:

* Contraindications to EIT examination and prone position
* Refusal of signing the informed consent

Primary outcomes:
measure: DeadSpace
timeFrame: 3 months
measure: Shunt
timeFrame: 3 months
measure: Ventilation-perfusion matching (VQmatch)
timeFrame: 3 months
measure: Global inhomogeneity index (VQmatch-GI)
timeFrame: 3 months
Secondary outcomes:
measure: Ventilation
timeFrame: 3 months
measure: Perfusion
timeFrame: 3 months
measure: Center of Ventilation (CoV)
timeFrame: 3 months
measure: Standard deviation of regional ventilation delay
timeFrame: 3 months
Other outcomes:
Locations:
city: Beijing
country: China
facility: PUMC
state: Beijing
Study officials:
affiliation: Peking Union Medical College
name: Yun Long, MD
role: PRINCIPAL_INVESTIGATOR
References: