Height Measurement Procedures Influence the Risk of Ventilator-induced Lung Injury in ARDS

NCT07595926 | Not Yet Recruiting

• 1 other identifier: PI2026_843_0061
• Study Type: interventional
• Target: 39
• Locations: 1 country
• Sites: 1

Brief Summary

Acute respiratory distress syndrome is characterized by heterogeneous lung injury, with dependent regions often collapsed and non-dependent regions relatively well-aerated, forming the so called "baby lung." Mechanical ventilation, while essential, can induce additional lung injury (VILI) via overdistension (baro/volutrauma) or repetitive alveolar collapse (atelectrauma). Protective ventilation strategies with low tidal volumes (VT 6-8 mL/kg predicted body weight, PBW) reduce mortality, but their efficacy relies on accurate PBW estimation, which is derived from patient height. In critical care, height measurement is often challenging, and common methods such as visual estimation or tape measurement can be inaccurate, leading to inappropriate VT settings and increased risk of lung stress and VILI. Alternative methods, including heel-to-knee distance and laser measurement, may offer more precise PBW estimation, yet their impact on lung mechanics in ARDS remains unexplored. This study addresses the knowledge gap by evaluating whether differences in height measurement methods significantly affect lung stress, tidal volume distribution, and ventilatory mechanics in ARDS patients. Patients' heights will be measured using five methods (stadiometer, visual, tape, laser, heel-to knee). Corresponding PBW and tidal volumes (VT = 6 mL/kg PBW) will be calculated and applied in randomized order, each for 30 minutes. Lung stress, ventilatory mechanics, gas exchange, and regional ventilation distribution will be assessed for each VT setting, preceded by a short alveolar recruitment maneuver. During the study, continuous monitoring of hemodynamics and oxygenation will be performed. Ventilatory parameters including plateau pressure, driving pressure, and transpulmonary pressures will be recorded. Electrical impedance tomography will assess regional tidal volume distribution. Each patient's participation is limited to approximately two hours with no further follow-up.

Conditions

Height; Acute Respiratory Distress Syndrome; Ventilator-Induced Lung Injury; Tidal Volume; Predicted Body Weight

Keywords

acute respiratory distress syndrome; ventilator-induced lung injury; tidal volume; predicted body weight; height

Outcome Measures

Primary Outcomes (1)

• Pulmonary stress

  Pulmonary stress assessed by measuring end-inspiration transpulmonary pressure using a balloon esophageal probe.

  one day

Secondary Outcomes (5)

• measured height variation

  one day

• predicted body weight variation

  one day

• tidal volume variation

  one day

• Transpulmonary pressures at end-expiratory

  one day

• Transpulmonary pressures at end-inspiratory intervals.

  one day

Study Arms (1)

ards patients

EXPERIMENTAL

Other: height measured

Interventions

height measured OTHER

Patients with ARDS will have their height measured using five different methods: stadiometer (reference), visual estimation, measuring tape, infrared laser, and heel-to-knee distance. For each height, the predicted body weight (PBW) and corresponding tidal volume (VT = 6 mL/kg PBW) will be calculated and applied in a randomized order, each for 30 minutes. During each VT period, lung stress (end-inspiratory transpulmonary pressure), ventilatory mechanics, gas exchange, and regional ventilation distribution (assessed using electrical impedance tomography) will be assessed. Prior to each VT application, a short alveolar recruitment maneuver will be performed to standardize lung volume.

ards patients

Eligibility Criteria

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

You may qualify if:

• Adult patient
• Mechanical ventilation on volumetric mode
• Sedated and curarized patient
• Diagnosis of ARDS according to the Berlin criteria
• Diagnosis of ARDS \< 48 hours
• Signed informed consent
• Affiliation with a social security or health insurance scheme

You may not qualify if:

• Patient opposing the use of his/her data for research purposes.
• Contraindication to placement of an esophageal balloon catheter (e.g., esophageal fistula, esophageal varices).
• Contraindication to strict supine positioning for height measurement (e.g., proven or suspected intracranial hypertension with intracranial pressure \>18 mmHg).
• Impossibility of measuring height with the reference method (stadiometer) due to deformity or amputation of both lower limbs.
• Patient under guardianship or curatorship, or deprived of liberty.
• Pregnant or postpartum patient, or patient currently breastfeeding.

Sponsors & Collaborators

• Centre Hospitalier Universitaire, Amiens: lead

Study Sites (1)

CHU Amiens

Amiens, 80480, France

Location

MeSH Terms

Conditions

Respiratory Distress Syndrome; Ventilator-Induced Lung Injury

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases; Respiration Disorders; Lung Injury

Central Study Contacts

Clément BRAULT, MD

CONTACT

33+322087831; brault.clement@chu-amiens.fr

Study Design

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

Study Record Dates

• First Submitted: April 28, 2026
• First Posted: May 19, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): May 1, 2028
• Study Completion (Estimated): May 1, 2028
• Last Updated: May 19, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)