Personalized Ventilator Settings for Patients on ECMO (PEEPECMO)
University of California, San Diego
Summary
While mechanical ventilation can be used to sustain life in those with lung injury, it, can further worsen lung injury or prevent lung healing resulting in high morbidity and mortality as seen in Acute Respiratory Distress Syndrome (ARDS). Using extracorporeal membrane oxygenation (ECMO), the highest level of life support also known as the heart-lung machine, investigators may minimize injury from mechanical ventilation to allow the lungs to heal; however, the optimal ventilator strategies while on ECMO are unknown. This study will evaluate personalized ventilator strategy compared to standard of care ventilation.
Description
While mechanical ventilation can be used to sustain life in those with severe ARDS, it, can further worsen lung injury or prevent lung healing resulting in high morbidity and mortality. Using ECMO, investigators may be able to minimize injury from mechanical ventilation to allow the lungs to to recover from ARDS; however, the optimal ventilator settings and therapies are unknown while on ECMO. This trial will randomize patients to personalized ventilator strategy vs. standard of care. Current ventilator guidelines while on V-V ECMO for ARDS use a one-size-fits-all approach - respiratory rate…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
1. History of Lung or Cardiac Transplantation, or definite bridge to transplantation 2. Patient is not committed to full support 3. Treating clinician refusal, or unwillingness to commit to controlled therapeutics (Esophageal Pressure Guided Positive End-Expiratory Pressure and neuromuscular blockade) 4. Inability to get informed consent from the patient or legally authorized representative (LAR) 5. Patients with contraindications to esophageal balloon placement or inability to successfully place an esophageal balloon will have personalized PEEP determined by electrical impedance tomography.…
Interventions
- DevicePersonalized Positive End-Expiratory Pressure (PEEP)
The personalized Positive End-Expiratory Pressure (PEEP) will be determined by esophageal manometry or electrical impedance tomography (EIT)
Location
- UC San Diego Health Jacobs Medical CenterLa Jolla, California