How PEEP changes ventilation–perfusion matching in two types of ARDS lungs
Official title: Effect of PEEP on Ventilartion/Perfusion Ratios According to Different Phenotypes in Patients With ARDS (France)
Run by University Hospital, Angers · NCT05578742 · Data updated 2026-11-12
This trial will test whether increasing or decreasing PEEP changes ventilation–perfusion matching in adults with moderate-to-severe ARDS who are sedated and on a ventilator.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 50 (estimated) |
| Sponsor | University Hospital, Angers Government |
| Locations | 1 site (Angers, Maine et Loire) |
| Status | Recruiting |
| Started | February 8, 2024 |
| Main results expected | August 2026 |
| Study ends | September 2026 |
| Registry record updated | December 8, 2025 |
| Trial ID | NCT05578742 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are adults with moderate-to-severe ARDS (PaO2/FiO2 ≤200 at PEEP 5 cmH2O), intubated and deeply sedated on controlled mechanical ventilation between 24 hours and 5 days after intubation, who have no contraindication to EIT.
✕Probably not a fit
Patients with pneumothorax, ongoing ECMO, severe chest wounds preventing EIT, BMI ≥35 kg/m2, pregnancy, legal protection status, or persistent hypotension (MAP <60 mmHg) are excluded and would not benefit from participation.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
Researchers will classify intubated ARDS patients by respiratory system elastance into two compliance-based phenotypes and then apply stepwise PEEP increases and decreases while measuring regional ventilation and perfusion with Electrical Impedance Tomography (EIT). The protocol enrolls adults 24 hours to 5 days after intubation who are deeply sedated and on controlled mechanical ventilation, excluding those with contraindications to EIT, ECMO, pneumothorax, very high BMI, pregnancy, or severe hemodynamic instability. EIT data will be used to quantify global and regional V/Q matching changes with each PEEP setting and compare responses between the low- and normal-compliance groups. The goal is to describe mechanistic differences in V/Q behavior that could explain variable gas-exchange responses to PEEP.
Why it matters
Potential benefit: If successful, this approach could help tailor PEEP settings to a patient’s lung mechanics to improve oxygenation and reduce ventilator-related harm.
How similar studies have gone: EIT has previously been used to map ventilation and perfusion and to show heterogeneous PEEP responses, but using elastance-defined compliance phenotypes to guide PEEP is relatively novel with limited prospective outcome data.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion criteria: * intubated patients with moderate and severe ARDS (Berlin definition, PaO2/FiO2 ≤200 mmHg at PEEP 5 cmH2O) * undergoing deep sedation * on controlled mechanical ventilation * between 24 hours and 5 days after intubation. Exclusion criteria: * age \<18 years old; pregnancy * patient undergoing legal protection * contra-indications to EIT (e. g. severe chest trauma or wounds) * pneumothorax; patient undergoing ECMO * patient with BMI ≥35 kg/m2 * hemodynamic instability with MAP \<60 mmHg despite vasopressors.
Where it's running
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Angers Hospital
Angers, Maine et Loire, France Recruiting
Study contacts
- Study coordinator: François Beloncle, MD
- Email: francois.Francois.Beloncle@chu-angers.fr
- Phone: +33 241 35 58 65
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.