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Assessing Lung Inhomogeneity During Ventilation for Acute Hypoxemic Respiratory Failure — ALIVE  

Acute Respiratory Distress Syndrome Clinical Trial

Official title:
Assessing Lung Inhomogeneity During Ventilation for Acute Hypoxemic Respiratory Failure

Clinical Trial Summary

Mechanical ventilation can cause damage by overstretching the lungs, especially when the lungs are collapsed or edematous. Raising ventilator pressures can reduce lung collapse and this can prevent overstretching from mechanical ventilation. It remains uncertain how much pressure (PEEP - positive end-expiratory pressure) should be used on the ventilator and how to identify patients who will benefit from higher ventilator pressures vs. lower ventilator pressures. The investigators are using a unique new imaging technology, electrical impedance tomography (EIT), to study this problem and to determine the safest and most effective ventilator pressure level. The results of this study will inform future trials of higher vs. lower PEEP strategies in mechanically ventilated patients.

Clinical Trial Description

Patients participating in this physiological cross-over randomized trial will undergo a series of PEEP maneuvers designed to assess lung recruitability, PEEP responsiveness, and optimal PEEP. EIT imaging and esophageal manometry will be employed throughout the protocol to quantify the effect of PEEP on lung function. Patients will be randomized to be ventilated at PEEP levels supplied by the ExPRESS strategy or by the EIT hyperdistention/collapse algorithm. The biological response will be assessed by measuring serum cytokines. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details
NCT number NCT03589482
Study type Interventional
Source University Health Network, Toronto
Contact
Status Completed
Phase N/A
Start date March 1, 2019
Completion date August 31, 2021
View Details
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