Detection of Right Ventricular Dysfunction by 2D Strain During Acute Respiratory Distress Syndrom (ARDS)

Acute respiratory distress syndrome (ARDS) and mechanical ventilation can lead to right ventricular dysfunction and ultimately right ventricular failure by increasing pulmonary vascular resistances and pressure load. This can be prevented by modifying ventilator settings, using vasopressors or inotropes or even by prone positionning.But to do so, right ventricular dysfonction has to be detected. Echocardiography has emerged as a first line tool to diagnose right heart failure. Recently, strain analysis showed promising results to detect early right ventricle abnormalities in other settings such as pulmonary hypertension or scleroderma. We therefore decided to determine whether 2D strain could help detect early right ventricular dysfunction in ARDS.

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Key information

Conditions

Acute Respiratory Distress Syndrome Acute Cor Pulmonale Cardiovascular Diseases Heart Diseases Heart Failure Lung Diseases Respiration Disorders Respiratory Distress Syndrome Respiratory Tract Diseases Right Heart Failure Right Ventricular Dysfunction Ventricular Dysfunction Ventricular Dysfunction, Right

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

University Hospital of Grenoble

Grenoble, Cedex 09, 38043, France

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

ARDS group

Inclusion criteria

Need for mechanical ventilation
ARDS criteria met: Respiratory failure not fully explained by cardiac failure, Pao2/FiO2<200, bilateral opacities on Chest imaging, all symptoms appeared within 1 week

Exclusion criteria

Predictable duration of mechanical ventilation shorter than 48 hours
Contraindication to transesophageal echocardiography

ALI group:

Inclusion criteria

Need for mechanical ventilation
ALI criteria met: Respiratory failure not fully explained by cardiac failure, Pao2/FiO2<300, bilateral opacities on Chest imaging, all symptoms appeared within 1 week

Exclusion criteria

Predictable duration of mechanical ventilation shorter than 48 hours

Control Group:

Inclusion criteria

Need for mechanical ventilation for a non-respiratory cause

Exclusion criteria

Need for FiO2>30%
Known cardiac abnormalities
Cardiac drugs intake during last 24 hours

Treatment and study plan

Primary outcomes

Right ventricle 2D strain

Time frame: Duration of mechanical ventilation

We will assess whether 2D strain can detect a right ventricular dysfunction as compared to standard echocardiographic parameters

Secondary outcomes

Mean right ventricle strain under ventilated patients

Time frame: at inclusion

We measure right ventricle strain (RV strain) in patients under mechanical ventilation for a non-respiratory cause. This allows us to determine the mean value of RV strain under ventilation when there is no respiratory failure.
Reproducibility between transthoracic and transesophageal strain measures

Time frame: Time of mechanical ventilation

In ARDS patients, we record a transthoracic and transesophageal echocardiography. We compare RV strain values obtained from transthoracic and transesophageal echocardiography.
NT pro BNP and pre pro endothelin plasma level

Time frame: At inclusion in ARDS patients

These assays are made based on the hypothesis they could help discriminate between patients who will develop a right ventricular dysfunction from those who will not. A blood sample is withdrawn at the same time as echocardiography only in the ARDS group.

Sponsors and collaborators

Lead sponsor

University Hospital, Grenoble

Other

Registry information

Acronym: STRAIN

Important dates

Study start: 2013
Primary completion: 2015
Study completion: 2017
First posted: Dec 31, 2012
Registry last updated: Nov 8, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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