EIT-guided PEEP personalization for trauma- and postoperative ARDS

Electrical Impedance Tomography-Guided Positive End-Expiratory Pressure Optimization in Patients With Trauma-Related and Postoperative Acute Respiratory Distress Syndrome

This trial tests whether using bedside electrical impedance tomography (EIT) to set PEEP helps adults with moderate to severe ARDS after trauma or major surgery breathe and oxygenate better.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 80 (estimated)
• Ages: 18 Years to 90 Years
• Sex: All
• Sponsor: Vietnam Military Medical University (Academic / other)
• Locations: 1 site (Hanoi)
• Trial ID: NCT07313644 on ClinicalTrials.gov

What this trial studies

This single-center, prospective randomized controlled trial enrolled adult intubated patients with moderate to severe ARDS following trauma or major surgery. Patients were randomized to PEEP titration guided by electrical impedance tomography (EIT) using a standardized protocol with deep sedation versus conventional lower PEEP/FiO2 settings per the ARDSNet table. The primary outcomes were oxygenation and respiratory mechanics, with secondary outcomes including 28-day survival, ventilator-free days, ICU and hospital length of stay, weaning success, adjunctive therapy use, barotrauma, and SOFA score changes. Supportive care and other ventilator settings followed ARDS Network recommendations throughout the study.

Who should consider this trial

Good fit: Ideal candidates are adult (18–90) intubated surgical ICU patients with trauma- or postoperative-associated moderate to severe ARDS who meet inclusion criteria and lack exclusion conditions.

Not a fit: Patients with contraindications such as pneumothorax or pneumomediastinum, severe brain injury, end‑stage disease, pregnancy or implanted electrical devices, or those already on advanced respiratory therapies are unlikely to benefit from this intervention.

Why it matters

Potential benefit: If successful, EIT-guided PEEP could provide more individualized lung protection, improving oxygenation and respiratory mechanics while potentially reducing ventilator days and barotrauma.

How similar studies have performed: Prior small trials and observational work have shown that EIT can improve regional ventilation targeting and short-term oxygenation, but clear evidence of improved clinical outcomes remains limited.

Eligibility criteria

Inclusion Criteria:

* Mechanically ventilated surgical intensive care patients with trauma- or postoperative-associated moderate to severe ARDS, as defined by the 2023 Global Definition of ARDS.

Exclusion Criteria:

* Age \<18 or \>90 years.
* Severe acute brain injury or acute stroke with Glasgow Coma Scale \<8.
* Thoracic trauma with pneumothorax or pneumomediastinum.
* End-stage diseases under palliative care (e.g., metastatic cancer, cirrhosis, end-stage renal disease).
* Severe multiorgan failure with expected survival \<7 days.
* Conditions requiring prolonged mechanical ventilation (e.g., Guillain-Barré syndrome, cervical spinal cord injury).
* Contraindications to hypercapnia (e.g., elevated intracranial pressure, acute coronary syndrome).
* Prior use of advanced respiratory therapies (e.g., ECMO, inhaled nitric oxide, prone positioning, high-frequency ventilation).
* Pregnancy, breastfeeding, or skin lesions at electrode placement sites.
* Implanted electrical devices interfering with EIT (e.g., pacemaker, ICD).
* Known allergy to electrode materials.
* Refusal to participate or concurrent enrollment in another study

Where this trial is running

Hanoi

• Center for Anesthesia and Surgical Intensive Care, Viet Duc University Hospital — Hanoi, Vietnam (Recruiting)

Study contacts

• Study coordinator: Nguyen Viet Minh

Conditions Acute Respiratory Syndrome Distress; Positive End-Expiratory Pressure; Electrical Impedance Tomography; Trauma and Postoperative Pulmonary Insufficiency; Acute respiratory syndrome distress; electrical impedance tomography; Trauma and Postoperative; blood oxygenation