Noninvasive Ventilation in Moderate-to-severe COVID-19-associated Acute Respiratory Distress-syndrome

Summary

Non-invasive ventilation can allow to avoid intubation and improve outcomes in moderate-to-severe COVID-19-associated acute respiratory distress-syndrome (ARDS). Data on NIV parameters adjustment based on expanded respiratory and gas exchange monitoring in COVID-19 associated ARDS is limited. Appropriate adjustment of the inspiratory positive airway pressure (IPAP) set as a point of the balance between minimal work of breathing (minimum point of W.Patrick scale for assessment of the accessory respiratory muscles and minimum diaphragm thickening fraction) and minimum tidal volume, and respiratory rate can decrease NIV failure in moderate-to-severe COVID-ARDS. The objective of the study is to evaluate the ability of non-invasive ventilation guided with expanded respiratory monitoring to decrease the intubation rate in in moderate-to-severe COVID-ARDS.

Conditions

• Covid19
• ARDS

Interventions

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Respiratory monitoring

Measurement of the tidal volume, peak inspiratory flow, inspiratory time, respiratory rate and the pressure gap during triggering on NIV and plateau pressure on mechanical ventilation

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Respiratory muscles ultrasound

Measurement of the diaphragm thickening fraction, assessment of the contraction of scalene and sternocleidomastoid muscles

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Electro impedance tomography

Measurement of the lung impedance changes in 4 quadrants, measurement of regional ventilation delay in 4 quadrants

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Capnography

Measurement of end-tidal carbon dioxide tension

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Arterial blood gas

Measurement of the oxygen partial pressure and the carbon dioxide partial pressure

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Quasistatic pressure-volume curve

Quasistatic pressure-volume curve

Sponsors & Collaborators

• I.M. Sechenov First Moscow State Medical University

  lead OTHER

Principal Investigators

• Andrey I Yaroshetskiy, MD, PhD, ScD · Sechenov University

Eligibility

Min Age

18 Years

Max Age

80 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-10-01

Primary Completion

2021-06-30

Completion

2021-08-31

FDA Device

Yes

Countries

• Russia

Study Locations