Vascular ARDS Recruitment After Inhaled Nitric Oxide
Status:
Not yet recruiting
Trial end date:
2026-05-30
Target enrollment:
Participant gender:
Summary
Acute respiratory distress syndrome (ARDS) is a condition where a person's lungs become
inflamed, which can be caused by infection, trauma, surgery, blood transfusion, or burn. ARDS
often leads to a situation where the person cannot breathe independently and needs machines'
help. Once the lungs are inflamed, the small air sacs responsible for exchanging gases (i.e.,
ventilation) and the blood flow in the lungs (i.e., perfusion) can be affected. In the past,
most research focused on studying ventilation physiology and how to help people breathe with
machines. Less was done on studying perfusion because it requires imaging techniques such as
computed tomography with the use of intravenous contrast and radiation. One treatment option
for low oxygen levels is inhaled nitric oxide (iNO), a gas that can dilate the lung blood
vessels and improve oxygenation; however, it is not always clear whether this treatment will
work. Electrical Impedance Tomography (EIT) is a bedside and accessible imaging technique
that is radiation-free and non-invasive and has the potential to detect changes in lung
perfusion. EITI can perform multiple measurements; it is portable and accessible. This
prospective interventional study aims to assess changes in regional blood perfusion in the
lungs of patients with ARDS in response to iNO utilizing EIT. The main questions it aims to
answer are:
1. If EIT can measure lung regional perfusion response to an iNO challenge of 20ppm for 15
minutes.
2. If EIT is comparable to dual-energy computed tomography (DECT), the gold-standard method
to detect changes in regional lung perfusion.
3. If EIT can be an imaging marker to identify ARDS severity
Participants will be divided into two cohorts:
1. Cohort 1 (n=60): Participants will be asked to be monitored by EIT before, during, and
after the administration of iNO (20 ppm) for 15 minutes (OFF-ON-OFF)
2. Cohort 2 (N=10): Participants will be asked to be monitored by EIT and DECT before and
during the administration of iNO (20 ppm) for 15 minutes (OFF-ON).