Extra Vascular Lung Water and Pulmonary Permeability in Critically Ill Patients With SARS-CoV-2 (COVID-19)

  • STATUS
    Recruiting
  • participants needed
    30
  • sponsor
    University Hospital, Montpellier
Updated on 16 February 2024
critical illness
mechanical ventilation
acute lung injury
respiratory distress
coronavirus
edema
covid-19
lung injury
SARS
critically ill
coronavirus infection
acute respiratory distress
acute respiratory syndrome (sars)
respiratory system

Summary

Acute respiratory distress syndrome (ARDS) is a syndromic definition of an acute lung injury with alteration of biomechanics (lower respiratory system compliance) mostly associated with increased lesional edema. Increase in Pulmonary Vascular Permeability Index (PVPI) accompanied with accumulation of excess Extravascular Lung Water (EVLW) is the hallmark of ARDS. In routine clinical practice, the investigators measure the EVLW and PVPI in ARDS patients, as suggested by expert's recommendations, using a transpulmonary thermodilution (TPTD) technique.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly recognized illness that has spread rapidly throughout Wuhan (Hubei province) to other provinces in China and around the world. Most critically ill patients with SARS-CoV-2 will present the criteria for the definition of ARDS. However, many of these patients have a particular form of ARDS with severe hypoxemia often associated with near normal respiratory system compliance. This combination is almost never seen in severe ARDS. Thus other mechanisms (including probably vascular mechanisms), that are still poorly described, have to be involved in SARS-CoV-2.

EVLW and PVPI have never been assessed in SARS-CoV-2 mechanically ventilated patients. The aim of this study is to evaluate these two parameters in order to best characterize and understand the mechanisms related to SARS-CoV-2.

Based on observation of several cases in intensive care units (ICU), the investigators hypothesize that there are following different SARS-CoV-2 patterns:

  1. Nearly normal compliance, low lung recruitability, normal EVLW and low PVPI.
  2. Low compliance due to increased edema, high lung recruitability, high EVLW and high PVPI.

Details
Condition Pulmonary Disease, Upper respiratory infection, Pneumonia, Pneumonia, ADULT RESPIRATORY DISTRESS SYNDROME, Covid 19
Age 18years - 99years
Clinical Study IdentifierNCT04376905
SponsorUniversity Hospital, Montpellier
Last Modified on16 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

COVID-19 critically ill patients
Invasive mechanical ventilation

Exclusion Criteria

Age under 18
Pregnancy
Legally protected adults
Contra-indication of using PiCCO device: jugular venous thrombosis, or severe chronic femoral/iliac artery occlusive disease
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