Physiological Studies in the Prone Position in Patients With ARDS

February 28, 2025 updated by: Zhou Yongfang, West China Hospital

The Respiratory Physiologic Efficacy of Prone Position and Its Association With Outcomes in ARDS: A Prospective Observational Cohort Study

The purpose of this study is to observe the changes of physiological indicators such as ventilation and oxygenation in the prone position of ARDS patients, to observe the change trend of each patient's indicators, and to observe whether different trends of indicators predict different prognosis of patients.

Study Overview

Status

Recruiting

Conditions

Detailed Description

PP has been shown to effectively improve the prognosis of patients with severe ARDS, but not all patients with ARDS can benefit from PP, and the implementation of the PP has a certain clinical risks and side effects, we lack a convenient predictors to guide doctors to determine whether patients should implement the PP. Clinical usually observe the P/F improved as whether PP treatment effective reference, but there are literature points out that the rising P/F after PP can not predict the better prognosis. one of the mechanisms for ARDS patients benefit from PP is proved to be improve V/Q, the change of the V/Q may determine whether the PP treatment effectively is an important indicator. PaO2:FiO2 ratio was usually used to evaluate the effect of PP, but some studies did not support this conclusion. PP has been shown to change ventilation-perfusion ratio, dead space may be better physiological indicators, simplify dead space ratio and Ventilatory ratio can be easily accessed at bedside and is associated with mortality of patients with ARDS. The purpose of this study is to observe the predictive value of P/F, VD-etCO2/VT, and VR on the treatment effect of ARDS undergoing PP.

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Sichuan
      • Chengdu, Sichuan, China, 610041
        • Recruiting
        • Department of Critical care medicine of West China Hospital
        • Principal Investigator:
          • Y F Zhou, MM
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

We conducted a prospective cohort study in a intensive care unit in West China Hospital, Sichuan University, China. Adult patients (age≥18years) who were diagnosed with moderate to severe ARDS according to the Berlin definition, received mechanical ventilation and prone positioning were included.

Description

Inclusion Criteria:

  1. Intubated patients
  2. Undergoing mechanical ventilation
  3. Moderate to severe ARDS
  4. Undergoing prone positioning
  5. Age≥18 years old

Exclusion Criteria:

  1. Pregnant
  2. Cardiac structural shunt
  3. Extracorporeal membrane oxygenation performed
  4. Undergo extracorporeal CO2 removal
  5. Pulmonary embolism
  6. Other situation that may affect the accuracy of PetCO2 monitoring
  7. Prone positioning session less than 10 hours

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
28 days without mechanical ventilation
Time Frame: From the date of enrollment to 28 days
Days without mechanical ventilation support within 28 days after enrollment
From the date of enrollment to 28 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
ICU mortality and in-hospital mortality
Time Frame: From the date of enrollment until the date of discharge, assessed up to 1 year
Prognostic measures will be recorded until discharge, such as ICU mortality and in-hospital mortality
From the date of enrollment until the date of discharge, assessed up to 1 year
Length of lCU stay and length of hospital stay
Time Frame: From the date of enrollment until the date of discharge, assessed up to 1 year.
Prognostic measures will be recorded until discharge, such as length of lICU stay and length of hospital stay in days.
From the date of enrollment until the date of discharge, assessed up to 1 year.
Respiratory physiological parameters.
Time Frame: From enrollment to Day 7.
Respiratory physiological parameters are collected at each time point (before prone positioning , every 4 hours after prone positioning, and 4 hours after turn back to supine position), such as PaO2/FiO2。
From enrollment to Day 7.
Indicators related to dead space
Time Frame: From enrollment to Day 7.
Indicators related to dead space are collected at each time point (before prone positioning , every 4 hours after prone positioning, and 4 hours after turn back to supine position), such as VR and dead space ratio, which were calculated by predicted body weight, partial pressure of carbon dioxide and end-tidal carbon dioxide
From enrollment to Day 7.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

West China Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2023

Primary Completion (Estimated)

June 1, 2025

Study Completion (Estimated)

June 1, 2025

Study Registration Dates

First Submitted

August 30, 2024

First Submitted That Met QC Criteria

September 3, 2024

First Posted (Actual)

September 19, 2024

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

February 28, 2025

Last Verified

February 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Prone position

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Any data collected during this study can be acquired from the correspondingauthor upon a reasonable request.

IPD Sharing Time Frame

Half a year after the publication of the research paper.

IPD Sharing Access Criteria

Any data collected during this study can be acquired from the correspondingauthor upon a reasonable request.

IPD Sharing Supporting Information Type

  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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