Using Electrical Impedance Tomography to Optimize Ventilator Settings in Patients with Severe Breathing Problems
Using Electrical Impedance Tomography-Guided Ventilator Settings to Reduce Mechanical Power in Acute Hypoxemic Respiratory Failure : An Exploratory Study
This study is trying to see if using a special imaging technique can help set ventilators better for patients with severe breathing problems like acute respiratory failure.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 17 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Mahidol University Academic / other |
| Locations | 1 site (Bangkok) |
| Trial ID | NCT06936618 on ClinicalTrials.gov |
What this trial studies
This exploratory study investigates how Electrical Impedance Tomography (EIT) can guide ventilator settings to improve mechanical power in patients suffering from acute hypoxemic respiratory failure (AHRF), including those with Acute Respiratory Distress Syndrome (ARDS). The study will enroll 17 patients requiring invasive mechanical ventilation and will utilize a standardized EIT-guided PEEP titration protocol to determine optimal ventilator settings. Key parameters such as lung mechanics, gas exchange, and safety outcomes will be assessed before and after the intervention. Patients will be monitored for up to 28 days to evaluate the impact on mechanical ventilation duration and overall outcomes.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18 and older diagnosed with acute hypoxemic respiratory failure who are expected to require invasive mechanical ventilation for at least 48 hours.
Not a fit: Patients with contraindications to EIT, severe obesity, or unstable cardiac conditions may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could lead to improved ventilation strategies that reduce the risk of ventilator-induced lung injury in critically ill patients.
How similar studies have performed: While the use of EIT in ventilator management is a relatively novel approach, preliminary studies have shown promising results in optimizing ventilator settings.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥ 18 years * Diagnosed with acute hypoxemic respiratory failure within 48 hours * Expected to require invasive mechanical ventilation ≥ 48 hours * On mechanical ventilation within 24 hours * Deep sedation and neuromuscular blockade Exclusion Criteria: * Pregnancy * Body mass index (BMI) \> 40 kg/m2 * Contraindications to using electrical impedance tomography, including * Presence of a pacemaker or automatic implantable cardioverter-defibrillator (AICD) * Inability to place the belt due to presence of surgical wounds dressing, thoracic or spinal cord trauma, recent thoracic surgery, etc. * High risk for PEEP titration * Hemodynamic instability defined as mean arterial pressure \< 65 mmHg despite optimization of fluid status and/or use of vasopressors * Unstable cardiac arrhythmias * Presence of lung bullae greater than 2 cm in diameter, identified on chest X-ray * Presence of pneumothorax or pneumomediastinum * Right-sided heart failure or severe pulmonary hypertension * Neurologic conditions associated with a risk of intracranial hypertension * Use of extracorporeal membrane oxygenation (ECMO) * Severe chronic respiratory disease, defined as follows: requiring home oxygen therapy, or previous lung function showing (FEV1 less than 20 ml/kg PBW, or FEV1/FVC less than 50% predicted value), or chronic hypercapnia (PaCO2 greater than 45 mmHg) and/or chronic hypoxemia (PaO2 less than 55 mmHg) on FIO2 = 0.21, or radiographic x-ray evidence of any chronic over-inflation or chronic interstitial infiltration, or chronic restrictive, obstructive, neuromuscular, chest wall or pulmonary vascular disease resulting in severe exercise restriction (unable to climb stairs or perform household duties, secondary polycythemia, severe pulmonary hypertension with mean pulmonary arterial pressure greater than 40 mmHg) * Decision to withhold life-sustaining treatment or palliative care. * Moribund status with an expected survival of less than 24 hours. * Refusal to provide informed consent
Where this trial is running
Bangkok
- Siriraj Hospital, Mahidol University — Bangkok, Thailand (Recruiting)
Study contacts
- Principal investigator: Ranistha Ratanarat, Associated Professor, MD — Siriraj Hospital
- Study coordinator: Jitanong Sootlek, MD, PCCM
- Email: jitanong9651@gmail.com
- Phone: +66954164563
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.