Comparing lateral and prone positioning in ARDS patients

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This study investigates the effects of lateral positioning (30°) and alternating positioning on pulmonary aeration in patients with moderate to severe Acute Respiratory Distress Syndrome (ARDS). It aims to determine if adding lateralization during prone positioning can enhance overall ventilation and improve oxygenation. The study will measure changes in pulmonary aeration using electrical impedance tomography and assess gas exchange parameters. It is a bicentric, open-label study with repeated measures to evaluate the effectiveness of this positioning strategy.

Why it matters

Who can join: the full rules

Inclusion criteria:

* Age of at least 18 years
* ARDS evolving for less than 5 days with a PaO2/FiO2 ratio (P/F ratio) \< 150 after optimization of PEEP (P/V curve, R/I ratio), curarization and without prior use of the PP since orotracheal intubation.
* Obtained written consent of the patient, one of his relatives or the previously designated trusted person. As soon as possible, the patient will be informed and his written consent will be obtained
* Beneficiary of health insurance coverage
* Possibility of participating in any other studies whose evaluation criteria do not interfere with those of the study

Non-inclusion criteria:

Patients with at least one of the following criteria will not be eligible:

* Refusal to participate
* Pregnant, parturient or breastfeeding women
* Intracranial pressure \> 30 mm Hg or cerebral perfusion pressure \< 60 mmHg
* Severe chronic respiratory disease with oxygen therapy or mechanical ventilation at home (except CPAP/BIPAP for obstructive sleep apnea)
* Chronic interstitial lung diseases
* Patients on ECMO
* Weight \> 100 kg
* Severe liver disease Child-Pugh score 12-15
* Pneumothorax
* SAPS II score \> 75 at inclusion
* Unstable spinal fracture
* Contraindications to EIT (pacemaker, implantable defibrillator, skin lesions between the 4th and 5th ribs).
* Withdrawal (except for ECMO) or witholding treatment decision
* Any other reason which, according to the investigator, could interfere with the evaluation of the study objectives
* Person under legal protection measure (guardianship, curatorship, etc.)
* Person deprived of liberty by a judiciary or administrative decision

Exclusion criteria:

\- Patients who will be unable to complete the 25-hour intervention due to worsening requiring ECMO, death or organizational problems will be excluded from the analysis.

Where it's running

• Bastia General Hospital
  Bastia, France, France Recruiting
• North Hospital Marseille
  Marseille, France, France Recruiting

Study contacts

• Study coordinator: Laurent Papazian, MD,PHD
• Email: laurent.papazian@ch-bastia.fr
• Phone: 0495591039

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Multicenter group study of sepsis and ARDS in China

  This study tests how sepsis and ARDS differ among adults across several Chinese hospitals and builds a biobank to understand why some patients do better or worse.

  Recruiting at 24 sites Shanghai Zhongshan Hospital · Xiamen, Fujian and 23 other locations · NCT07863908

• Blood viscosity in ARDS: a look at how thick the blood is

  This study tests whether blood viscosity is higher in adults with ARDS and whether viscosity relates to their breathing and blood flow issues.

  Recruiting Hospices Civils de Lyon · Lyon · NCT07823296

• TwitchView-guided Atracurium Dose Adjustment in ICU Patients

  This trial tests whether using a TwitchView EMG monitor to guide atracurium dosing in ICU patients reduces the total amount of the drug given without compromising care.

  Recruiting Fu Jen Catholic University Hospital · New Taipei City · NCT07807046

• Fibrinogen-to-Albumin Ratio as a Predictor of ARDS in Traumatic Brain Injury

  This study tests whether the fibrinogen-to-albumin ratio can predict who among adults with traumatic brain injury will develop acute respiratory distress syndrome (ARDS).

  Recruiting Tanta University · Tanta, Gharbia Governorate · NCT07664358

• Gastric versus postpyloric feeding for adults with ARDS on prone ventilation

  This trial will test whether feeding through a stomach tube (nasogastric) or a tube placed past the stomach (nasojejunal) works better for adults with moderate to severe ARDS who are on a ventilator and positioned face-down.

  Recruiting Southeast University, China · Nanjing, Jiangsu · NCT07362537

• Using higher PEEP with mask noninvasive ventilation for people with pneumonia or ARDS

  This trial will test whether giving higher PEEP through a mask during noninvasive ventilation helps adults with pneumonia or ARDS avoid intubation and improve oxygenation.

  Recruiting Chongqing Medical University · Chongqing · NCT07298889

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.