Effect of Continuous Anterior Chest Compression on Ventilation/Perfusion Ratio and Hemodynamics (HemodyCACC)

January 14, 2026 updated by: Assistance Publique - Hôpitaux de Paris

Evaluation of the Effects of Continuous Anterior Chest Compression on Ventilation/Perfusion Ratios and Hemodynamics in SDRA

Intro:

The mortality of acute respiratory distress syndrome (ARDS) remains high (40%), and may be aggravated by ventilation-induced lung injury (VILI), the main mechanisms of which are:

  1. Anterior region overdistension,
  2. Atelectrauma in the posterior regions. Positive expiratory pressure (PEEP) adjusted on the ventilator during ARDS aims to recruit posterior pulmonary territories in order to limit atelectrauma but is accompanied by a concomitant risk of overdistension of anterior territories.

Recent data suggest that continuous anterior chest compression (CACC) could limit the overdistension of the anterior regions by decreasing the compliance of the anterior chest wall and thus the regional transpulmonary pressure, while promoting the redistribution of ventilation to the posterior territories.

The effects of CCAC on ventilation/perfusion ratios and hemodynamics are unknown.

Hypothesis/Objective :

The participants hypothesize that during ARDS, CCAC:

  1. Improves ventilation/perfusion ratios by decreasing both anterior territory dead space effect and posterior territory shunt,
  2. Induce an improvement in cardiac output by decreasing right ventricular afterload (decrease in capillary compression related to the overdistension of the anterior territories and decrease in hypoxic vasoconstriction of the condensed territories).

Objective:

Primary outcome :

To evaluate the effects of CCAC on ventilation/perfusion ratios during moderate to severe ARDS.

Secondary outcome :

To evaluate the effects of CCAC on hemodynamics : left heart morphology, systolic and diastolic function, cardiac output, right heart morphology, systolic function, pulmonary hypertension, volemia.

Method In patient with moderate to severe ARDS, CACC is performed manually and the pressure applied will be maintained between 60 and 80 cmH2O.

Electrical impedance tomography of ventilation and perfusion will be used for the measurement of the percentage of areas with normal VA/Q ratios, areas of shunt and areas of dead space effect.

Left heart morphology, systolic and diastolic function, cardiac output, right heart morphology, systolic function, pulmonary hypertension, volemia will be evaluated by using echocardiography.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Not Applicable

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

  • France
    • Creteil
      • Créteil, Creteil, France, 94010
        • Henri Mondor Hospital

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

Description

Inclusion Criteria:

  • Age ≥ 18 years
  • ARDS moderate to severe according to the Berlin criteria
  • Patient receiving continuous sedation and curarization
  • Free and informed consent from the patient or family member

Exclusion Criteria:

  • Pregnancy
  • Adult patient subject to a legal protection measure (tutor, curator, etc.)
  • Patients with a pacemaker, automatic implantable cardioverter defibrillator,
  • Contraindications to thoracic belt placement (e.g., thoracic or spinal cord trauma, recent thoracic surgery)
  • Undrained pneumothorax, bronchopleural fistula
  • Hemodynamic instability (i.e., use of intravenous fluids of more than 10 mL/kg or vasopressors 2 mg/h of norepinephrine or 0.5 mg/h of epinephrine)

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

  • Primary Purpose: Other
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Patient with moderate to severe ARDS under sedation andcontinuous curarization
Other: Continuous anterior chest compression
CACC is performed manually and the pressure applied will be maintained between 60 and 80 cmH2O.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
percentage of areas with normal VA/Q ratios, areas of shunt and areas of dead space effect.
Time Frame: 28 days
demonstration that CACC may improve VA/Q ratio by using electrical impedance tomography
28 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
CACC may induce a modification in cardiac output by decreasing right ventricular afterload
Time Frame: 28 days
measurement of cardiac output with echocardiography via : left ventricle outflow tract velocity time integral cm)
28 days
CACC may induce a modification in patient with right ventricular injury
Time Frame: 28 days
RV/LV : right ventricle end-diastolic ratio, to LV end-diastolic diameter ratio, sLV eccentricity index : systolic left ventricle eccentricity index; ACP : Acute cor pulmonale
28 days
CACC may induce a modification in right systolic function
Time Frame: 28 days
measurement of right systolic function paramaters : TAPSE (mm) , S' annular tricuspid wave (m/s), RVFAC (%)
28 days
CACC may induce a modification in left systolic function
Time Frame: 28 days
LVEF : left ventricular ejection fraction
28 days
CACC may induce a modification in ventilation distribution
Time Frame: 28 days
ventilation distribution antero-posterior and right/left, assessed by electrical impedance tomography
28 days
CACC may induce a modification in lung perfusion distribution
Time Frame: 28 days
lung perfusion distribution antero-posterior and right/left assessed by electrical impedance tomography
28 days

Collaborators and Investigators

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

Sponsor

Assistance Publique - Hôpitaux de Paris

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)

February 28, 2023

Primary Completion (Actual)

June 30, 2024

Study Completion (Actual)

June 30, 2024

Study Registration Dates

First Submitted

February 28, 2023

First Submitted That Met QC Criteria

November 19, 2024

First Posted (Actual)

November 21, 2024

Study Record Updates

Last Update Posted (Actual)

January 15, 2026

Last Update Submitted That Met QC Criteria

January 14, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • APHP230065

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

DATAS ARE OWN BY ASSISTANCE PUBLIQUE - HOPITAUX DE PARIS, PLEASE CONTACT SPONSOR FOR FURTHER INFORMATION

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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