Patients with acute respiratory distress syndrome are placed on mechanical ventilation, and the adjustment of ventilator parameters is an important step in their care, in particular positive expiratory pressure, applied at the end of breathing.
The goal of this study is to learn if continuous anterior chest compression works as well as electrical impedance tomography for positive expiratory pressure titration.
Researchers will compare the two methods for each patient, in a randomly determined order : continuous anterior chest compression and electrical impedance tomography.
Participants will :
* have a pep titration with both techniques * be included in the study for 28 days
Age ≥ 18 years
Moderate to severe ARDS according to the Berlin criteria
Patient receiving sedation and continuous curarization
Free and informed consent from the patient or their loved one
ECMO
Pneumothorax
Chest trauma in the last 3 months
Uncontrolled shock (noradrenaline > 5 mg/h)
Single group
PEEP titrations
Other interventionAssessment of ideal PEEP using electrical impedance tomography will be performed. The evaluation of PEEP using the thorax compression maneuver method will be carried out. A blood sample (the "blood gases") will be taken at the ideal PEEP determined by electrical impedance tomography and at the ideal PEEP determined by the manual chest compression maneuver.
PEPCTAC
PEPCTAC (unit : cmH2O)
PEPCAC
PEPCAC (unit : cmH2O)
PEPEIT
PEPEIT (unit : cmH2O)
Percentage of collapse at PEPCTAC
Percentage of collapse at PEPCTAC
Percentage of collapse at PEPCAC
Percentage of collapse PEPCAC
Percentage of collapse at PEPEIT
Percentage of collapse at PEPEIT
Compare respiratory mechanics for PEPCTAC and PEPCAC and PEPEIT
Respiratory mechanics at PEPCTAC and PEPCAC ans PEPEIT : peak and plateau pressure, driving pressure, respiratory system compliance, pulmonary and parietal compliance, respiratory system resistance, end-expiratory transpulmonary pressure, stress index at each PEEP level
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