Continuous Negative Abdominal Pressure in ARDS (CNAP in ARDS) (CNAP in ARDS)
Acute Respiratory Distress Syndrome
About this trial
This is an interventional supportive care trial for Acute Respiratory Distress Syndrome
Eligibility Criteria
Inclusion Criteria:
- Patients ≧ 18 years old
- Patients with moderate to severe ARDS as per the Berlin definition (PaO2/FiO2 ≤200mmHg)
- Patients with absence of any significant cardiopulmonary disease
Exclusion Criteria:
Contraindication to CNAP
a. open abdominal wounds or drainage tubes; b. Acute brain Injury with intracranial pressure >30 mm Hg or cerebral perfusion pressure <60 mmHg; c. Decompensated heart insufficiency or acute coronary syndrome; d. Major hemodynamic instability: Mean arterial pressure lower than 60 mm Hg despite adequate fluid resuscitation and two vasopressors or increase of vasopressor dose by 30% in the next 6 hours; f. Unstable spine, femur, or pelvic fractures; g. Pregnancy; h. Pneumothorax;
- Contraindication to EIT electrode placement: Burns, chest wall bandaging limiting electrode placement
- Severe liver insufficiency (Child-Pugh score > 7) or fulminant hepatic failure
- Major respiratory acidosis or PaCO2 > 60 mmHg
- Severe COPD (according to the GOLD criteria defined as severe = FEV1: 30-50% or very severe = FEV1 < 30%)
- Clinical judgement of the attending physician
Sites / Locations
- St. Michael's HospitalRecruiting
Arms of the Study
Arm 1
Experimental
Single arm
Patients with ARDS will be placed inside of a Continuous Negative Abdominal Pressure Device. Negative pressure will be applied to the abdomen as an adjunct to positive pressure ventilation