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Electrical Impedance TomographyNCT05406427

Monitorings the Physiological Mechanism of Airway Pressure Release Ventilation in ARDS Patients by EIT

An observational study of Electrical Impedance Tomography and ARDS, run by Union Hospital, Tongji Medical College, Huazhong University of Science and Technology at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Effects of airway pressure release ventilation on pulmonary ventilation, shunt and perfusion in patients with ARDS Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Electrical Impedance Tomography, ARDS
How many people
30 participants
Where
1 siteChina
Study dates
1 Mar 2022to 1 Mar 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • Adult, Older adult

Study population: Include as many subjects as possible according to the research protocol

Who may be able to join

  • 18 years old < age < 80 years old
  • Diagnosed as moderate or severe ARDS according to the Berlin 2014 definition
  • Predicted APRV mechanical ventilation for more than 72 hours

Who cannot join

  • Excluded if any of the following exclusion criteria are met:
  • APRV contraindications such as pneumothorax, severe chronic obstructive pulmonary disease, severe asthma, intracranial hypertension
  • Pregnant women
  • Severe cardiac dysfunction (New York Heart Association class III or IV, acute coronary syndrome or sustained ventricular tachyarrhythmia), right heart enlargement due to chronic cardiopulmonary disease, cardiogenic shock or cardiac hand
  • Refractory shock
  • BMI>35

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

    Wuhan, Hubei, 430000

    xin zhao, master, 15927336285 ext. 027-85351607, 619641364@qq.com

    Recruiting

Other trials in China

About this study

Official title: Monitorings the Physiological Mechanism of Airway Pressure Release Ventilation(APRV) in Acute Respiratory Distress Syndrome (ARDS) Patients by Electrical Impedance Tomography(EIT)

Effects of airway pressure release ventilation on pulmonary ventilation, shunt and perfusion in patients with ARDS

Read the detailed description

Effects of airway pressure release ventilation on respiratory mechanisms including ventilation distribution, intrapulmonary shunt and V/Q match in lungs of ARDS evaluated by EIT at different time points.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. tidal volume distribution during APRV at 24 hours after APRV

    we will use electrical impedance tomography(EIT) to monitor tidal volume distribution during APRV

    Measured: 24 hours after APRV mechanical ventilation

Secondary outcomes (30)
  1. tidal volume distribution during APRV

    tidal volume distribution electrical impedance tomography(EIT) during APRV

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 48, 72 hours after APRV mechanical ventilation

  2. Intrapulmonary shunt during APRV

    Intrapulmonary shunt percent represented regions that were only perfused calculated as the slope of regional impedance-time curves after saline bolus injection evaluated by EIT

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  3. V/Q match

    V/Q match is monitored by EIT

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  4. tidal volume(Vt)

    Vt is the volume of air inhaled or exhaled per breath during mechanical ventilation

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  5. Plateau pressure

    Plateau pressure is the airway pressure at the end of inspiratory pause

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  6. Positive end breath pressure

    Positive end breath pressure(PEEP) is the airway pressure at the end of each breath which is set by clinicians

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  7. Driving pressure(DP)

    DP=Plateau pressure-PEEP

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  8. Compliances(Cs)

    Cs=DP/Vt

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  9. Peak pressure

    Peak pressure is the maximum pressure in the airway during ventilation occurs at the end of inspiration.

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  10. Mean pressure

    Mean pressure is the average airway pressure over a number of breathing cycles

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  11. Right ventricular area fractional change

    Right ventricular area fractional change is a simple and repeatable ultrasound method for evaluating right ventricular function. Methods: The right ventricular end-diastolic area (RVEDA) and right ventricular end- systolic area (RVESA) were measured on the apical four-chamber section by two-dimensional ultrasound. RVAC=(RVEDA- RVESA)/RVEDA*100%.

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  12. Tricuspid annular systolic displacement (TAPSE)

    TAPSE:Measurement method: TAPSE was measured on the four-chamber section of the apex of the heart by M-mode ultrasound. the sampling line was placed at the side wall of the tricuspid valve ring, parallel to the free wall of the right ventricle as far as possible, and the displacement of the tricuspid valve ring was measured from the end of diastole to the end of systole.

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  13. Tricuspid annular systolic S' velocity (TS')

    TS' is an objective and accurate ultrasound technique for evaluating right ventricular function.Measurement method:The sample volume was applied to the free wall of the RV and the peak velocity of tricuspid annulus motion was measured in the four-chamber section of the apex by tissue doppler imaging (TDI).

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  14. Right ventricular end-diastolic area/left ventricular end-diastolic area (RVEDA/LVEDA)

    RVEDA/LVEDA a simple and repeatable ultrasound method for evaluating dynamics changes of right ventricular function.Methods: The right ventricular end-diastolic area (RVEDA) and left ventricular end-systolic area (LVEDA) were measured on the apical four-chamber section by two-dimensional ultrasound.

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  15. Pulmonary circulatory resistance (PVR)

    Increased PVR can lead to deterioration of RV function.Pulse Doppler imaging (PWD) was used to obtain the pulmonary artery flow spectrum from the pulmonic valve on the short axial section of the parasternal great vessels.

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  16. stroke volume index(SVI)

    SVI is monitored by two-dimension ultrasound

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  17. cardiac index (CI)

    The amount of blood pumped by the heart in liters per minute divided by the body surface area in square meters

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  18. Heart rate(HR)

    HR is one of the basic parameters of hemodynamics

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  19. Systolic blood pressure(SBP)

    SBP is one of the basic parameters of hemodynamics

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  20. Mean arterial pressure (MAP)

    MAP is one of the basic parameters of hemodynamics

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  21. Cardiac output(CO)

    The amount of blood expelled from one ventricle per minute

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  22. Stroke volume

    The amount of blood expelled from one ventricle during a single cardiac beat

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  23. Arterial partial pressure of oxygen (PaO2)

    PaO2 is one of the key indicators of patients' respiratory status which can be obtained from arterial blood gas analysis.

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  24. Arterial partial pressure of carbon dioxide(PaCO2)

    PaCO2 is one of the key indicators of pulmonary ventilation which can be obtained from arterial blood gas analysis.

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  25. oxygenation index

    oxygenation index=PaO2/fraction of inspired oxygen

    Measured: Before APRV mechanical ventilation and 2, 6, 12, 24, 48, 72 hours after APRV mechanical ventilation

  26. Sequential Organ Failure Assessment score

    The higher the Sequential Organ Failure Assessment(SOFA) score(0~24), the higher the disease risk factor and the higher the mortality rate

    Measured: 2 hours within admission to ICU and 24 hours after inclusion in the study

  27. Acute Physiology and Chronic Health Evaluation score

    The higher the Acute Physiology and Chronic Health Evaluation(APACHE II) score(0~71), the higher the disease risk factor and the higher the mortality rate. In particular, the accuracy of group patient prediction is high.In particular, the accuracy of group patient prediction is high.

    Measured: 2 hours within admission to ICU and 24 hours after inclusion in the study

  28. Duration of ventilation after randomization

    Time to mechanical ventilation in the ICU after randomization or time to mechanical ventilation after randomization until extubation or death

    Measured: from the day of randomization to the day of extubation or the day of death,assessed up to 90 days

  29. Mortality at 28 days after randomization

    Mortality at 28 days after randomization

    Measured: 28 days after the beginning of randomization

  30. ICU length of stay

    Duration of ICU stay after randomization until surviving transfer out of ICU

    Measured: the whole period of stay in ICU from the day of randomization to the day of discharge from ICU or the day of death,assessed up to 90 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jun 2022
  2. Study start1 Mar 2022
  3. Primary completion1 Mar 2024 (estimated)
  4. Study completion1 Mar 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05406427
Sponsor's protocol ID
EIT20220109
Status last verified
Jun 2022
First submitted
5 Apr 2022
Last updated
8 Nov 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Zhou Y, Jin X, Lv Y, Wang P, Yang Y, Liang G, Wang B, Kang Y. Early application of airway pressure release ventilation may reduce the duration of mechanical ventilation in acute respiratory distress syndrome. Intensive Care Med. 2017 Nov;43(11):1648-1659. doi: 10.1007/s00134-017-4912-z. Epub 2017 Sep 22.

    PubMed 28936695
  • Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Pesenti A; LUNG SAFE Investigators; ESICM Trials Group. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries. JAMA. 2016 Feb 23;315(8):788-800. doi: 10.1001/jama.2016.0291.

    PubMed 26903337
  • Mauri T, Spinelli E, Scotti E, Colussi G, Basile MC, Crotti S, Tubiolo D, Tagliabue P, Zanella A, Grasselli G, Pesenti A. Potential for Lung Recruitment and Ventilation-Perfusion Mismatch in Patients With the Acute Respiratory Distress Syndrome From Coronavirus Disease 2019. Crit Care Med. 2020 Aug;48(8):1129-1134. doi: 10.1097/CCM.0000000000004386.

    PubMed 32697482
  • Safaee Fakhr B, Araujo Morais CC, De Santis Santiago RR, Di Fenza R, Gibson LE, Restrepo PA, Chang MG, Bittner EA, Pinciroli R, Fintelmann FJ, Kacmarek RM, Berra L. Bedside monitoring of lung perfusion by electrical impedance tomography in the time of COVID-19. Br J Anaesth. 2020 Nov;125(5):e434-e436. doi: 10.1016/j.bja.2020.08.001. Epub 2020 Aug 7. No abstract available.

    PubMed 32859359
  • Kollisch-Singule M, Emr B, Smith B, Ruiz C, Roy S, Meng Q, Jain S, Satalin J, Snyder K, Ghosh A, Marx WH, Andrews P, Habashi N, Nieman GF, Gatto LA. Airway pressure release ventilation reduces conducting airway micro-strain in lung injury. J Am Coll Surg. 2014 Nov;219(5):968-76. doi: 10.1016/j.jamcollsurg.2014.09.011. Epub 2014 Sep 19.

    PubMed 25440027

Questions about this trial

What is this clinical trial studying?

An observational study of Electrical Impedance Tomography and ARDS, run by Union Hospital, Tongji Medical College, Huazhong University of Science and Technology at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 8 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact xin zhao, master (15927336285 ext. 027-85351607, 619641364@qq.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

tidal volume distribution during APRV at 24 hours after APRV (time frame: 24 hours after APRV mechanical ventilation). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05406427, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Nov 2022.

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