Open Lung Strategy in Critically Ill Morbid Obese Patients

Obesity Clinical Trial

Official title: Open Lung Strategy in Critically Ill Morbid Obese Patients Lung Imaging and Heart-lung Interaction

Status Active, not recruiting

Clinical Trial Summary

The goal of this interventional crossover study in morbidly obese intubated and mechanically ventilated patients is to describe the respiratory mechanics and the heart-lung interaction at titrated positive end-expiratory pressure levels following a recruitment maneuver with transthoracic echocardiography and electric impedance tomography imaging.

Clinical Trial Description

Obese patients under mechanical ventilation are more likely to develop atelectasis as a consequence of the increased abdominal weight. Atelectasis is the primary responsible for respiratory insufficiency and impossibility to wean obese patients from respiratory support.

In a previous study we demonstrated the efficacy of the application of titrated PEEP levels following a recruitment maneuver in obese patients, i.e. improvement in respiratory mechanics and gas exchanges without negative hemodynamic effects.

The application of lung and heat imaging will allow us to quantitatively describe:

• Increase in aerated lung tissue (reduction of atelectasis)

• Reduction of over-inflation of the ventilated regions

• Recoupling of ventilation and perfusion

• Improvement in right heart function by reduction of right heart afterload ;

Related Conditions & MeSH terms

• Heart Failure
• Obesity
• Pulmonary Atelectasis
• Pulmonary Valve Insufficiency
• Respiratory Insufficiency
• Respiratory Mechanics
• Right-Sided Heart Failure

• NCT number: NCT02503241
• Study type: Interventional
• Source: Massachusetts General Hospital
• Status: Active, not recruiting
• Phase: N/A
• Start date: April 2016
• Completion date: June 30, 2022