Effect of Continuous Anterior Chest Compression on Ventilation/Perfusion Ratio and Hemodynamics

NCT06699017 | Completed

• 1 other identifier: APHP230065
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Intro: The mortality of acute respiratory distress syndrome (ARDS) remains high (40%), and may be aggravated by ventilation-induced lung injury (VILI), the main mechanisms of which are:

1. 1.Anterior region overdistension,
2. 2.Atelectrauma in the posterior regions. Positive expiratory pressure (PEEP) adjusted on the ventilator during ARDS aims to recruit posterior pulmonary territories in order to limit atelectrauma but is accompanied by a concomitant risk of overdistension of anterior territories.
3. 3.Improves ventilation/perfusion ratios by decreasing both anterior territory dead space effect and posterior territory shunt,
4. 4.Induce an improvement in cardiac output by decreasing right ventricular afterload (decrease in capillary compression related to the overdistension of the anterior territories and decrease in hypoxic vasoconstriction of the condensed territories).

Conditions

Acute Respiratory Distress Syndrome

Keywords

ARDS; cardiac output; ventilation perfusion ratio

Outcome Measures

Primary Outcomes (1)

• percentage of areas with normal VA/Q ratios, areas of shunt and areas of dead space effect.

  demonstration that CACC may improve VA/Q ratio by using electrical impedance tomography

  28 days

Secondary Outcomes (6)

• CACC may induce a modification in cardiac output by decreasing right ventricular afterload

  28 days

• CACC may induce a modification in patient with right ventricular injury

  28 days

• CACC may induce a modification in right systolic function

  28 days

• CACC may induce a modification in left systolic function

  28 days

• CACC may induce a modification in ventilation distribution

  28 days

Study Arms (1)

Patient with moderate to severe ARDS under sedation andcontinuous curarization

EXPERIMENTAL

Patient with moderate to severe ARDS under sedation andcontinuous curarization

Other: Continuous anterior chest compression

Interventions

Continuous anterior chest compression OTHER

CACC is performed manually and the pressure applied will be maintained between 60 and 80 cmH2O.

Patient with moderate to severe ARDS under sedation andcontinuous curarization

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 18 years
• ARDS moderate to severe according to the Berlin criteria
• Patient receiving continuous sedation and curarization
• Free and informed consent from the patient or family member

You may not qualify if:

• Pregnancy
• Adult patient subject to a legal protection measure (tutor, curator, etc.)
• Patients with a pacemaker, automatic implantable cardioverter defibrillator,
• Contraindications to thoracic belt placement (e.g., thoracic or spinal cord trauma, recent thoracic surgery)
• Undrained pneumothorax, bronchopleural fistula
• Hemodynamic instability (i.e., use of intravenous fluids of more than 10 mL/kg or vasopressors 2 mg/h of norepinephrine or 0.5 mg/h of epinephrine)

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris: lead

Study Sites (1)

Henri Mondor hospital

Créteil, Creteil, 94010, France

Location

MeSH Terms

Conditions

Respiratory Distress Syndrome

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases; Respiration Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Patient with moderate to severe ARDS under sedation and curarization keep on going

Study Record Dates

• First Submitted: February 28, 2023
• First Posted: November 21, 2024
• Study Start: February 28, 2023
• Primary Completion: June 30, 2024
• Study Completion: June 30, 2024
• Last Updated: January 15, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)