How torso tilt and ventilator PEEP affect lung opening in ARDS

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 multicenter physiological observational study measures how changing trunk inclination interacts with positive end-expiratory pressure (PEEP) and lung recruitability in intubated adults with moderate-to-severe ARDS. Participants undergo standardized lung recruitment maneuvers and decremental PEEP steps while respiratory mechanics and regional aeration are monitored using bedside tools such as electrical impedance tomography and conventional ventilator measurements. Investigators compare effects of different head-of-bed inclinations on end-expiratory transpulmonary pressure, recruitment of previously collapsed units, and signs of overdistension. The protocol is performed at tertiary hospitals in China and enrolls sedated, mechanically ventilated patients who meet the Berlin criteria for moderate-to-severe ARDS.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Intubated moderate and severe ARDS according to the Berlin definition (PaO2/FiO2 ratio \<= 200 mmHg)
* Under continuous sedation with or without paralysis

Exclusion Criteria:

* Age \<18 years
* Bronchopleural fistula
* Pure COPD exacerbation
* Contraindication to EIT monitoring (e.g. burns, pacemaker, thoracic wounds limiting electrode belt placement)
* Hemodynamic instability (Systolic BP \< 75 mmHg or MAP \< 60 mmHg despite vasopressors and/or heart rate \< 55 bpm)
* Contraindications to mobilization (e.g., intracranial hypertension, spinal cord injury)
* Intra-abdominal hypotension (IAP≥12mmHg)
* Pregnancy
* Attending physician deems the transient application of high airway pressures to be unsafe

Where it's running

• Zhongda Hospital, Southeast University
  Nanjing, Jiangsu, China Recruiting
• The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital
  Jinan, Shandong, China Recruiting
• West China Hospital of Sichuan University
  Chengdu, Sichuan, China Not yet recruiting

Study contacts

• Study coordinator: Fengmei Guo, M.D
• Email: fmguo2022@163.com
• Phone: +8618255127433

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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.