Avalanche-like opening of airways during ventilation in ARDS
Avalanche Phenomenon During Airways Opening in Acute Respiratory Distress Syndrome
Poitiers University Hospital · NCT05224323
This project will test whether airways in adults with moderate-to-severe ARDS open in an 'avalanche' pattern during mechanical ventilation.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 50 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Poitiers University Hospital (other) |
| Locations | 1 site (Poitiers) |
| Trial ID | NCT05224323 on ClinicalTrials.gov |
What this trial studies
This observational protocol enrolls adults with moderate-to-severe ARDS early after diagnosis who are invasively ventilated without spontaneous breathing. Investigators will record airway pressure and flow, esophageal pressure, and ventilation distribution while performing controlled inflation maneuvers. The collected signals will be analyzed to detect whether distal airways open unevenly in a rapid, cascade-like sequence during lung inflation. Results aim to clarify mechanisms of atelectrauma and inform safer ventilator settings.
Who should consider this trial
Good fit: Adults (≥18) with moderate-to-severe ARDS within 72 hours of meeting the Berlin criteria who are sedated/paralyzed and receiving invasive mechanical ventilation without spontaneous breathing are ideal candidates.
Not a fit: Patients with tracheostomy, pneumothorax, bronchopleural fistula, severe hypoxemia, hemodynamic instability, suspected intracranial hypertension, COPD, pacemakers/defibrillators, or decisions to withhold/withdraw life-sustaining measures are excluded and unlikely to benefit.
Why it matters
Potential benefit: If confirmed, the findings could help clinicians set ventilator pressures to reduce repetitive airway collapse and lung injury.
How similar studies have performed: Animal experiments and mathematical models have suggested avalanche-like airway opening, but this phenomenon has not been described in humans before.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥ 18 * Moderate-to-severe acute respiratory distress syndrome within the first 72 hours after meeting the Berlin definition criteria: * Within 1 week of a known clinical insult or new or worsening respiratory symptoms; * Bilateral opacities (not fully explained by effusions, lobar/lung collapse, or nodules); * Respiratory failure not fully explained by cardiac failure or fluid overload; * PaO2/FiO2 ≤ 200 mmHg with positive end-expiratory pressure ≥ 5 cmH2O. * Absence of spontaneous breathing efforts * Consent to participate to the study from the patient and/or its surrogate Exclusion Criteria: * Pneumothorax * Broncho-pleural fistula * Tracheostomy * Hemodynamic instability * Severe hypoxemia * Suspected of proven intracranial hypertension * Chronic obstructive lung disease * Pacemaker or defibrillator * Decision to withhold of withdraw life-sustaining measures * Under protection
Where this trial is running
Poitiers
- CHU Poitiers — Poitiers, France (RECRUITING)
Study contacts
- Study coordinator: Rémi Coudroy, MD, PhD
- Email: remi.coudroy@chu-poitiers.fr
- Phone: + 33 5 49 44 40 07
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Acute Respiratory Distress Syndrome