Effect of Transpulmonary MP on Prognosis of Patients With Severe ARDS Treated With VV-ECMO

Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18-75
SponsorBeijing Chao Yang Hospital

About this trial

Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a salvage treatment for severe acute respiratory distress syndrome (ARDS). With the large-scale implementation of VV-ECMO in critical care medicine departments in China, significant progress has been made in treating severe ARDS. However, the patient mortality rate remains high. The pathophysiological essence of ARDS is an imbalance between the body's oxygen supply and demand, causing tissue and cell hypoxia, organ dysfunction, and even death. The VV-ECMO treatment process still requires mechanical ventilation assistance. However, inappropriate mechanical ventilation settings can lead to ventilator-related lung injury (VILI). In recent years, mechanical power has gradually attracted everyone's attention and is considered the cause of VILI. The transpulmonary mechanical power is more accurate to the energy directly performed to the lung tissue. Transpulmonary mechanical energy has a specific value in judging the prognosis of mechanically ventilated patients, but its clinical significance in treating patients with VV-ECMO is unclear. This study aimed to explore the value of transpulmonary mechanical power in predicting the prognosis of patients with severe ARDS patients treated with VV-ECMO.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Meet the diagnostic criteria of Berlin's definition for ARDS;

Receiving VV-ECMO support.

Disqualifiers

Patients had been on high pressure (Ppeak >35 cm H2O) and a high fraction of inspired oxygen (FiO2>0.8) ventilation for >7 days;

Patients had a contraindication to heparinization;

Patients had an irreversible neurological injury;

Patients had severe chronic lung disease with life expectancy <6 months.

Trial population

Severe ARDS patients treated with VV-ECMO

Trial design

Design model

Cohort

Time perspective

Prospective

Treatments tested in this trial

  • Transpulmonary pressure

    Procedure/Surgery

    Use transpulmonary pressure to guide ventilator setting in ECMO for severe ARDS patients.

Treatment groups

100 Participants
are divided into 1 treatment group
Group A: Transpulmonary pressure group1 intervention

Trial outcomes

Primary outcomes

1

Patients successfully weaned from VV-ECMO

Weaning VV-ECMO more than 48 hours with stable oxygenation and no need to re-establish ECMO

Time frame
After patients enrolled 60 days

Secondary outcomes

1

60-day mortality

Mortality rate at 60 days of VV-ECMO support

Time frame
After patients enrolled 60 days

Other outcomes

Sponsors and contacts

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