Comparison of Different PEEP Titration Strategies Using Electrical Impedance Tomography in Patients With ARDS (DELTA)
Comparison of Different Positive End-expiratory Pressure Titration Strategies Using ELectrical Impedance Tomography in Patients With Acute Respiratory Distress Syndrome : the DELTA Physiological Study
The aim of the this study is to assess the short term physiological effects of 3 ventilation strategies for adult patients with ARDS admitted to intensive care unit.
Two of those strategies are based on electrical impedance tomography (EIT) monitoring.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Angers, France, 49100
- CHU Angers
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- patients with moderate to severe ARDS, defined by the Berlin consensus, at 12 to 48h from diagnosis
- PaO2/FiO2 ratio < 150 mmHg
- Patient affiliated to or beneficiary of a health care plan
- Consent obtained from patient's SDM
Exclusion Criteria:
- Pneumothorax
- Contraindication to the insertion of a nasogastric tube with an esophageal balloon
- Contraindication to the use of Electrical impedance tomography
- Pregnancy, lactating or parturient woman
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: A-B-A-C
Four consecutive steps (45 min per step) are tested in the following order: Peep titration strategy according to Express method (A) - Peep titration strategy according to overdistension and collapse estimation (B) - Peep titration strategy according to Express method (A) - Peep titration strategy according to estimation of lung inhomogeneity (C)
|
Patients are ventilated in randomized order with three different ventilation strategies (A,B and C)
|
|
Experimental: A-C-A-B
Four consecutive steps (45 min per step) are tested in the following order: Peep titration strategy according to Express method (A) - Peep titration strategy according to estimation of lung inhomogeneity (C) - Peep titration strategy according to Express method (A) - Peep titration strategy according to overdistension and collapse estimation (B)
|
Patients are ventilated in randomized order with three different ventilation strategies (A,B and C)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in PaO2 (mmHg)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance!
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in PaCO2 (mmHg)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Plateau pressure (cmH2O)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Positive end expiratory pressure (cmH2O)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Expiratory and inspiratory transpulmonary pressure (cmH2O)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Regional ventilation distribution (%)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Center of ventilation (%)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Overdistension and collapsus (%)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Global and regional end expiratory lung impedance changes (IU)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
End expiratory lung volume (mL)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Blood pressure (mmHg)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Heart rate (bpm)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
|
Cardiac output (L/min)
Time Frame: Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
As it is a physiological study, all the outcomes will be analyzed with the same importance
|
Time : 0 ; 45 minutes ; 90 minutes ; 135 minutes ; 180 minutes
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 49RC19_0249
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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