<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04486729</url>
  </required_header>
  <id_info>
    <org_study_id>10.2020</org_study_id>
    <nct_id>NCT04486729</nct_id>
  </id_info>
  <brief_title>Respiratory Mechanics and Gas Exchange Characteristics in Patient With SARS-CoV-2</brief_title>
  <official_title>Respiratory System Mechanics and Gas Exchange Characteristics Applying Different Ventilatory Strategies in Patients With SARS-CoV-2</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Sanatorio Anchorena San Martin</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Sanatorio Anchorena San Martin</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The combination of different ventilatory strategies and its effects on respiratory mechanics&#xD;
      and gas exchange in patients under mechanical ventilation with acute respiratory distress&#xD;
      syndrome secondary to coronavirus-19 has been scarcely described.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Investigation in mechanically ventilated patients with with acute respiratory distress&#xD;
      syndrome (ARDS) secondary to coronavirus-19 (COVID-19) is emerging due to presumed&#xD;
      differences with typical ARDS from other origin. Considering these issues, the effects of&#xD;
      ventilatory strategies such as positive end expiratory pressure, end inspiratory pause and&#xD;
      fraction of inspired oxygen on respiratory mechanics and gas exchange must be studied in&#xD;
      order to characterize the behavior of COVID-19 ARDS during invasive mechanical ventilation&#xD;
      and choose the best combination of ventilatory settings.&#xD;
&#xD;
      In this study the investigators will evaluate the changes in respiratory mechanics and gas&#xD;
      exchange produced by low and high positive end expiratory pressure, low and high inspired&#xD;
      oxygen fraction and the application of end inspiratory pause during volume controlled&#xD;
      mechanical ventilation.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Actual">July 1, 2020</start_date>
  <completion_date type="Anticipated">October 20, 2020</completion_date>
  <primary_completion_date type="Anticipated">October 10, 2020</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Case-Crossover</observational_model>
    <time_perspective>Cross-Sectional</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Driving transpulmonary pressure (cmH2O)</measure>
    <time_frame>10 minutes</time_frame>
    <description>The driving transpulmonary pressure will be evaluated between the high and low PEEP condition using the formula: driving transpulmonary pressure = driving airway pressure - driving esophageal pressure (cmH2O).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Bohr dead space fraction (%)</measure>
    <time_frame>10 minutes</time_frame>
    <description>The Bohr dead space fraction will be evaluated with high PEEP between the condition with end inspiratory pause and with no end inspiratory pause application using the formula: Bohr dead space fraction = Alveolar pressure of CO2 (PACO2) - Expired pressure of CO2 (PECO2) / PACO2</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Shunt fraction (%)</measure>
    <time_frame>10 minutes</time_frame>
    <description>The shunt fraction will be evaluated with low PEEP between the condition with high fraction of oxygen to achieve a saturation goal of 96-98% and the condition with low fraction of oxygen to achieve a saturation goal of 88-92%. The shunt fraction will be calculated using the formula: Qs/Qt = (capillary oxygen content - arterial oxygen content)/(capillary oxygen content - venous oxygen content)</description>
  </primary_outcome>
  <enrollment type="Anticipated">15</enrollment>
  <condition>Covid19</condition>
  <condition>ARDS, Human</condition>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>High PEEP with end inspiratory pause</intervention_name>
    <description>Applying a PEEP value 10 cmH2O higher than the lower inflection point of the pressure-volume curve of the respiratory system with end inspiratory pause addition in volumen control ventilation</description>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Low PEEP - FiO2 high</intervention_name>
    <description>Applying a PEEP value equal to the lower inflection point of the pressure-volume curve of the respiratory system with a FiO2 necessary to achieve a SpO2 96-98%</description>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>High PEEP without end inspiratory pause</intervention_name>
    <description>Applying a PEEP value 10 cmH2O higher than the lower inflection point of the pressure-volume curve of the respiratory system without end inspiratory pause addition in volumen control ventilation</description>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Low PEEP - FiO2 low</intervention_name>
    <description>Applying a PEEP value equal to the lower inflection point of the pressure-volume curve of the respiratory system with a FiO2 necessary to achieve a SpO2 88-92%</description>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        Patients with ARDS secondary to COVID-19 under invasive mechanical ventilation&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Older than 18 years old&#xD;
&#xD;
          -  less than 72 hs since ARDS diagnosis&#xD;
&#xD;
          -  Moderate to severe ARDS&#xD;
&#xD;
          -  central venous catheter and arterial line available&#xD;
&#xD;
          -  Need of neuromuscular blocking agents&#xD;
&#xD;
          -  Supine position&#xD;
&#xD;
          -  Informed consent accepted&#xD;
&#xD;
          -  Airway opening pressure lower than 20 cmH2O&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  RASS target higher than -5&#xD;
&#xD;
          -  COPD diagnosis&#xD;
&#xD;
          -  Pneumothorax&#xD;
&#xD;
          -  Intracraneal Hypertension&#xD;
&#xD;
          -  Pregnancy&#xD;
&#xD;
          -  Cardiac inssuficiency uncompensated&#xD;
&#xD;
          -  Chest wall deformity&#xD;
&#xD;
          -  Bronchopleural fistula&#xD;
&#xD;
          -  Contraindication to use esophageal manometry&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_contact>
    <last_name>Javier H Dorado, PT</last_name>
    <phone>(054) 114164 4262</phone>
    <email>javierhdorado@gmail.com</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Joaquin Pérez, PT</last_name>
    <phone>(054) 02245 505907</phone>
    <email>licjoaquinperez@hotmail.com</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Sanatorio Anchorena San Martin</name>
      <address>
        <city>San Martin</city>
        <state>Buenos Aires</state>
        <country>Argentina</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Javier H Dorado, PT</last_name>
      <phone>(054) 1141644262</phone>
      <email>javierhdorado@gmail.com</email>
    </contact>
  </location>
  <location_countries>
    <country>Argentina</country>
  </location_countries>
  <reference>
    <citation>Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, Wang H, Wan J, Wang X, Lu Z. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020 Jul 1;5(7):811-818. doi: 10.1001/jamacardio.2020.1017. Erratum In: JAMA Cardiol. 2020 Jul 1;5(7):848.</citation>
    <PMID>32219356</PMID>
  </reference>
  <reference>
    <citation>Ziehr DR, Alladina J, Petri CR, Maley JH, Moskowitz A, Medoff BD, Hibbert KA, Thompson BT, Hardin CC. Respiratory Pathophysiology of Mechanically Ventilated Patients with COVID-19: A Cohort Study. Am J Respir Crit Care Med. 2020 Jun 15;201(12):1560-1564. doi: 10.1164/rccm.202004-1163LE. No abstract available.</citation>
    <PMID>32348678</PMID>
  </reference>
  <reference>
    <citation>ARDS Definition Task Force; Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012 Jun 20;307(23):2526-33. doi: 10.1001/jama.2012.5669.</citation>
    <PMID>22797452</PMID>
  </reference>
  <reference>
    <citation>Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, Camporota L. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. 2020 Jun;46(6):1099-1102. doi: 10.1007/s00134-020-06033-2. Epub 2020 Apr 14. No abstract available.</citation>
    <PMID>32291463</PMID>
  </reference>
  <reference>
    <citation>Chen L, Del Sorbo L, Grieco DL, Junhasavasdikul D, Rittayamai N, Soliman I, Sklar MC, Rauseo M, Ferguson ND, Fan E, Richard JM, Brochard L. Potential for Lung Recruitment Estimated by the Recruitment-to-Inflation Ratio in Acute Respiratory Distress Syndrome. A Clinical Trial. Am J Respir Crit Care Med. 2020 Jan 15;201(2):178-187. doi: 10.1164/rccm.201902-0334OC.</citation>
    <PMID>31577153</PMID>
  </reference>
  <reference>
    <citation>Tusman G, Gogniat E, Madorno M, Otero P, Dianti J, Ceballos IF, Ceballos M, Verdier N, Bohm SH, Rodriguez PO, San Roman E. Effect of PEEP on Dead Space in an Experimental Model of ARDS. Respir Care. 2020 Jan;65(1):11-20. doi: 10.4187/respcare.06843. Epub 2019 Oct 15.</citation>
    <PMID>31615922</PMID>
  </reference>
  <reference>
    <citation>Aguirre-Bermeo H, Moran I, Bottiroli M, Italiano S, Parrilla FJ, Plazolles E, Roche-Campo F, Mancebo J. End-inspiratory pause prolongation in acute respiratory distress syndrome patients: effects on gas exchange and mechanics. Ann Intensive Care. 2016 Dec;6(1):81. doi: 10.1186/s13613-016-0183-z. Epub 2016 Aug 24.</citation>
    <PMID>27558174</PMID>
  </reference>
  <reference>
    <citation>Santos C, Ferrer M, Roca J, Torres A, Hernandez C, Rodriguez-Roisin R. Pulmonary gas exchange response to oxygen breathing in acute lung injury. Am J Respir Crit Care Med. 2000 Jan;161(1):26-31. doi: 10.1164/ajrccm.161.1.9902084.</citation>
    <PMID>10619793</PMID>
  </reference>
  <reference>
    <citation>Pan C, Chen L, Lu C, Zhang W, Xia JA, Sklar MC, Du B, Brochard L, Qiu H. Lung Recruitability in COVID-19-associated Acute Respiratory Distress Syndrome: A Single-Center Observational Study. Am J Respir Crit Care Med. 2020 May 15;201(10):1294-1297. doi: 10.1164/rccm.202003-0527LE. No abstract available.</citation>
    <PMID>32200645</PMID>
  </reference>
  <reference>
    <citation>Chen L, Del Sorbo L, Grieco DL, Shklar O, Junhasavasdikul D, Telias I, Fan E, Brochard L. Airway Closure in Acute Respiratory Distress Syndrome: An Underestimated and Misinterpreted Phenomenon. Am J Respir Crit Care Med. 2018 Jan 1;197(1):132-136. doi: 10.1164/rccm.201702-0388LE. No abstract available.</citation>
    <PMID>28557528</PMID>
  </reference>
  <reference>
    <citation>Tobin MJ. Basing Respiratory Management of COVID-19 on Physiological Principles. Am J Respir Crit Care Med. 2020 Jun 1;201(11):1319-1320. doi: 10.1164/rccm.202004-1076ED. No abstract available.</citation>
    <PMID>32281885</PMID>
  </reference>
  <reference>
    <citation>Talmor D, Sarge T, Malhotra A, O'Donnell CR, Ritz R, Lisbon A, Novack V, Loring SH. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med. 2008 Nov 13;359(20):2095-104. doi: 10.1056/NEJMoa0708638. Epub 2008 Nov 11.</citation>
    <PMID>19001507</PMID>
  </reference>
  <reference>
    <citation>Yoshida T, Amato MBP, Grieco DL, Chen L, Lima CAS, Roldan R, Morais CCA, Gomes S, Costa ELV, Cardoso PFG, Charbonney E, Richard JM, Brochard L, Kavanagh BP. Esophageal Manometry and Regional Transpulmonary Pressure in Lung Injury. Am J Respir Crit Care Med. 2018 Apr 15;197(8):1018-1026. doi: 10.1164/rccm.201709-1806OC.</citation>
    <PMID>29323931</PMID>
  </reference>
  <reference>
    <citation>Tahvanainen J, Meretoja O, Nikki P. Can central venous blood replace mixed venous blood samples? Crit Care Med. 1982 Nov;10(11):758-61. doi: 10.1097/00003246-198211000-00012.</citation>
    <PMID>7140317</PMID>
  </reference>
  <reference>
    <citation>Monnet X, Teboul JL. Passive leg raising: five rules, not a drop of fluid! Crit Care. 2015 Jan 14;19(1):18. doi: 10.1186/s13054-014-0708-5. No abstract available.</citation>
    <PMID>25658678</PMID>
  </reference>
  <reference>
    <citation>Iannuzzi M, De Sio A, De Robertis E, Piazza O, Servillo G, Tufano R. Different patterns of lung recruitment maneuvers in primary acute respiratory distress syndrome: effects on oxygenation and central hemodynamics. Minerva Anestesiol. 2010 Sep;76(9):692-8. Epub 2010 May 14.</citation>
    <PMID>20820146</PMID>
  </reference>
  <reference>
    <citation>Odenstedt H, Lindgren S, Olegard C, Erlandsson K, Lethvall S, Aneman A, Stenqvist O, Lundin S. Slow moderate pressure recruitment maneuver minimizes negative circulatory and lung mechanic side effects: evaluation of recruitment maneuvers using electric impedance tomography. Intensive Care Med. 2005 Dec;31(12):1706-14. doi: 10.1007/s00134-005-2799-6. Epub 2005 Sep 22.</citation>
    <PMID>16177920</PMID>
  </reference>
  <verification_date>July 2020</verification_date>
  <study_first_submitted>July 21, 2020</study_first_submitted>
  <study_first_submitted_qc>July 23, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">July 27, 2020</study_first_posted>
  <last_update_submitted>July 23, 2020</last_update_submitted>
  <last_update_submitted_qc>July 23, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">July 27, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Sanatorio Anchorena San Martin</investigator_affiliation>
    <investigator_full_name>Matias Accoce</investigator_full_name>
    <investigator_title>Head of physical therapy department</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Respiratory Distress Syndrome</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04486729
org study id: 10.2020
nct id: NCT04486729
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
The combination of different ventilatory strategies and its effects on respiratory mechanics
      and gas exchange in patients under mechanical ventilation with acute respiratory distress
      syndrome secondary to coronavirus-19 has been scarcely described.
Investigation in mechanically ventilated patients with with acute respiratory distress
      syndrome (ARDS) secondary to coronavirus-19 (COVID-19) is emerging due to presumed
      differences with typical ARDS from other origin. Considering these issues, the effects of
      ventilatory strategies such as positive end expiratory pressure, end inspiratory pause and
      fraction of inspired oxygen on respiratory mechanics and gas exchange must be studied in
      order to characterize the behavior of COVID-19 ARDS during invasive mechanical ventilation
      and choose the best combination of ventilatory settings.

      In this study the investigators will evaluate the changes in respiratory mechanics and gas
      exchange produced by low and high positive end expiratory pressure, low and high inspired
      oxygen fraction and the application of end inspiratory pause during volume controlled
      mechanical ventilation.
observational model: Case-Crossover
time perspective: Cross-Sectional
measure: Driving transpulmonary pressure (cmH2O)
time frame: 10 minutes
description: The driving transpulmonary pressure will be evaluated between the high and low PEEP condition using the formula: driving transpulmonary pressure = driving airway pressure - driving esophageal pressure (cmH2O).
measure: Bohr dead space fraction (%)
time frame: 10 minutes
description: The Bohr dead space fraction will be evaluated with high PEEP between the condition with end inspiratory pause and with no end inspiratory pause application using the formula: Bohr dead space fraction = Alveolar pressure of CO2 (PACO2) - Expired pressure of CO2 (PECO2) / PACO2
measure: Shunt fraction (%)
time frame: 10 minutes
description: The shunt fraction will be evaluated with low PEEP between the condition with high fraction of oxygen to achieve a saturation goal of 96-98% and the condition with low fraction of oxygen to achieve a saturation goal of 88-92%. The shunt fraction will be calculated using the formula: Qs/Qt = (capillary oxygen content - arterial oxygen content)/(capillary oxygen content - venous oxygen content)
intervention type: Other
intervention name: High PEEP with end inspiratory pause
description: Applying a PEEP value 10 cmH2O higher than the lower inflection point of the pressure-volume curve of the respiratory system with end inspiratory pause addition in volumen control ventilation
intervention type: Other
intervention name: Low PEEP - FiO2 high
description: Applying a PEEP value equal to the lower inflection point of the pressure-volume curve of the respiratory system with a FiO2 necessary to achieve a SpO2 96-98%
intervention type: Other
intervention name: High PEEP without end inspiratory pause
description: Applying a PEEP value 10 cmH2O higher than the lower inflection point of the pressure-volume curve of the respiratory system without end inspiratory pause addition in volumen control ventilation
intervention type: Other
intervention name: Low PEEP - FiO2 low
description: Applying a PEEP value equal to the lower inflection point of the pressure-volume curve of the respiratory system with a FiO2 necessary to achieve a SpO2 88-92%
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Javier H Dorado, PT
phone: (054) 114164 4262
email: javierhdorado@gmail.com
last name: Joaquin Pérez, PT
phone: (054) 02245 505907
email: licjoaquinperez@hotmail.com
facility: 
status: Recruiting
contact: 
country: Argentina
citation: Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, Wang H, Wan J, Wang X, Lu Z. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020 Jul 1;5(7):811-818. doi: 10.1001/jamacardio.2020.1017. Erratum In: JAMA Cardiol. 2020 Jul 1;5(7):848.
PMID: 32219356
citation: Ziehr DR, Alladina J, Petri CR, Maley JH, Moskowitz A, Medoff BD, Hibbert KA, Thompson BT, Hardin CC. Respiratory Pathophysiology of Mechanically Ventilated Patients with COVID-19: A Cohort Study. Am J Respir Crit Care Med. 2020 Jun 15;201(12):1560-1564. doi: 10.1164/rccm.202004-1163LE. No abstract available.
PMID: 32348678
citation: ARDS Definition Task Force; Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012 Jun 20;307(23):2526-33. doi: 10.1001/jama.2012.5669.
PMID: 22797452
citation: Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, Camporota L. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. 2020 Jun;46(6):1099-1102. doi: 10.1007/s00134-020-06033-2. Epub 2020 Apr 14. No abstract available.
PMID: 32291463
citation: Chen L, Del Sorbo L, Grieco DL, Junhasavasdikul D, Rittayamai N, Soliman I, Sklar MC, Rauseo M, Ferguson ND, Fan E, Richard JM, Brochard L. Potential for Lung Recruitment Estimated by the Recruitment-to-Inflation Ratio in Acute Respiratory Distress Syndrome. A Clinical Trial. Am J Respir Crit Care Med. 2020 Jan 15;201(2):178-187. doi: 10.1164/rccm.201902-0334OC.
PMID: 31577153
citation: Tusman G, Gogniat E, Madorno M, Otero P, Dianti J, Ceballos IF, Ceballos M, Verdier N, Bohm SH, Rodriguez PO, San Roman E. Effect of PEEP on Dead Space in an Experimental Model of ARDS. Respir Care. 2020 Jan;65(1):11-20. doi: 10.4187/respcare.06843. Epub 2019 Oct 15.
PMID: 31615922
citation: Aguirre-Bermeo H, Moran I, Bottiroli M, Italiano S, Parrilla FJ, Plazolles E, Roche-Campo F, Mancebo J. End-inspiratory pause prolongation in acute respiratory distress syndrome patients: effects on gas exchange and mechanics. Ann Intensive Care. 2016 Dec;6(1):81. doi: 10.1186/s13613-016-0183-z. Epub 2016 Aug 24.
PMID: 27558174
citation: Santos C, Ferrer M, Roca J, Torres A, Hernandez C, Rodriguez-Roisin R. Pulmonary gas exchange response to oxygen breathing in acute lung injury. Am J Respir Crit Care Med. 2000 Jan;161(1):26-31. doi: 10.1164/ajrccm.161.1.9902084.
PMID: 10619793
citation: Pan C, Chen L, Lu C, Zhang W, Xia JA, Sklar MC, Du B, Brochard L, Qiu H. Lung Recruitability in COVID-19-associated Acute Respiratory Distress Syndrome: A Single-Center Observational Study. Am J Respir Crit Care Med. 2020 May 15;201(10):1294-1297. doi: 10.1164/rccm.202003-0527LE. No abstract available.
PMID: 32200645
citation: Chen L, Del Sorbo L, Grieco DL, Shklar O, Junhasavasdikul D, Telias I, Fan E, Brochard L. Airway Closure in Acute Respiratory Distress Syndrome: An Underestimated and Misinterpreted Phenomenon. Am J Respir Crit Care Med. 2018 Jan 1;197(1):132-136. doi: 10.1164/rccm.201702-0388LE. No abstract available.
PMID: 28557528
citation: Tobin MJ. Basing Respiratory Management of COVID-19 on Physiological Principles. Am J Respir Crit Care Med. 2020 Jun 1;201(11):1319-1320. doi: 10.1164/rccm.202004-1076ED. No abstract available.
PMID: 32281885
citation: Talmor D, Sarge T, Malhotra A, O'Donnell CR, Ritz R, Lisbon A, Novack V, Loring SH. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med. 2008 Nov 13;359(20):2095-104. doi: 10.1056/NEJMoa0708638. Epub 2008 Nov 11.
PMID: 19001507
citation: Yoshida T, Amato MBP, Grieco DL, Chen L, Lima CAS, Roldan R, Morais CCA, Gomes S, Costa ELV, Cardoso PFG, Charbonney E, Richard JM, Brochard L, Kavanagh BP. Esophageal Manometry and Regional Transpulmonary Pressure in Lung Injury. Am J Respir Crit Care Med. 2018 Apr 15;197(8):1018-1026. doi: 10.1164/rccm.201709-1806OC.
PMID: 29323931
citation: Tahvanainen J, Meretoja O, Nikki P. Can central venous blood replace mixed venous blood samples? Crit Care Med. 1982 Nov;10(11):758-61. doi: 10.1097/00003246-198211000-00012.
PMID: 7140317
citation: Monnet X, Teboul JL. Passive leg raising: five rules, not a drop of fluid! Crit Care. 2015 Jan 14;19(1):18. doi: 10.1186/s13054-014-0708-5. No abstract available.
PMID: 25658678
citation: Iannuzzi M, De Sio A, De Robertis E, Piazza O, Servillo G, Tufano R. Different patterns of lung recruitment maneuvers in primary acute respiratory distress syndrome: effects on oxygenation and central hemodynamics. Minerva Anestesiol. 2010 Sep;76(9):692-8. Epub 2010 May 14.
PMID: 20820146
citation: Odenstedt H, Lindgren S, Olegard C, Erlandsson K, Lethvall S, Aneman A, Stenqvist O, Lundin S. Slow moderate pressure recruitment maneuver minimizes negative circulatory and lung mechanic side effects: evaluation of recruitment maneuvers using electric impedance tomography. Intensive Care Med. 2005 Dec;31(12):1706-14. doi: 10.1007/s00134-005-2799-6. Epub 2005 Sep 22.
PMID: 16177920
responsible party type: Principal Investigator
investigator affiliation: Sanatorio Anchorena San Martin
investigator full name: Matias Accoce
investigator title: Head of physical therapy department
mesh term: Respiratory Distress Syndrome
sharing ipd: Undecided