Using Electrical Impedance Tomography to Optimize Ventilator Settings in Patients with Severe Breathing Problems

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 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.

Why it matters

Who can join: the full rules

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 it's running

• 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

Similar studies

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

• Spontaneous vs Controlled Mechanical Ventilation in Acute Hypoxemic Respiratory Failure

  This study tests whether allowing spontaneous breathing or using controlled ventilation is better for adults with acute hypoxemic respiratory failure who need invasive mechanical ventilation.

  Recruiting Oslo University Hospital · Oslo, Oslo · NCT07463885

• Prognostic model for Acute Respiratory Distress Syndrome using Electrical Impedance Tomography

  This study is trying to see if a new way of measuring lung function can help doctors predict how well patients with Acute Respiratory Distress Syndrome (ARDS) will do and tailor their treatment accordingly.

  Recruiting at 4 sites Union Hospital, Tongji Medical College, Huazhong University of Science and Technology · Guangzhou, Guangdong and 3 other locations · NCT06967207

• Pulse Wave vs Saline Bolus EIT to measure lung perfusion in ARDS

  This study tests whether pulse wave EIT or saline bolus EIT can best show lung blood flow in ARDS patients on mechanical ventilation.

  Recruiting Union Hospital, Tongji Medical College, Huazhong University of Science and Technology · Wuhan, Hubei · NCT07908368

• Understanding immune patterns and ECMO strategies to help adults with severe ARDS

  This study tests how different immune and clinical patterns in adults with moderate-to-severe ARDS respond to ECMO and lung-protective care, aiming to improve outcomes.

  Recruiting at 16 sites Southeast University, China · Beijing, Beijing Municipality and 38 other locations · NCT07726940

• Optimal corticosteroid dosing for ARDS: short vs. prolonged therapy

  This trial tests different corticosteroid doses and treatment lengths to see which helps adults with ARDS who are on ventilators.

  Recruiting Phase 4 National Taiwan University Hospital · Taipei · NCT07711964

• How ventilator modes affect abdominal pressure and tube tolerance in ICU patients

  This observational study tests how different mechanical ventilation modes influence intra-abdominal pressure and gastric tube tolerance in adults who need ventilation in the ICU.

  Recruiting Damanhour University · Damanhūr · NCT07687303

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.