[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"pediatric-acute-respiratory-distress-syndrome\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:pediatric-acute-respiratory-distress-syndrome":27},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,2,0,[8,45],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":28,"overallStatus":32,"whyStopped":4,"lastUpdateSubmitDate":33,"lastUpdatePostDateStruct":34,"startDateStruct":37,"completionDateStruct":39,"leadSponsor":41,"locationsCount":44},"100568660","pediatric-positive-end-expiratory-pressure-peep-titration-using-electrical-impedence-tomography-eit-100568660",false,"NCT06684119","Pediatric Positive End Expiratory Pressure (PEEP) Titration Using Electrical Impedence Tomography (EIT)","Assessing Optimal Positive End-expiratory Pressure (PEEP) Using Electrical Impedance Tomography (EIT) During a PEEP Titration Protocol in Mechanically Ventilated Children with Pediatric Acute Respiratory Distress Syndrome (PARDS)","Inclusion Criteria:\n\n* Any person who is less than 18 years of age\n* is on invasive mechanical ventilation\n* is not spontaneously breathing\n* meets PARDS criteria\n\nExclusion Criteria:\n\n* Contraindication to the use of EIT\n* Hemodynamic instability\n* Contraindications to hypercapnia\n* patients with uncuffed endotracheal or tracheostomy tubes\n* diagnosis of pneumothorax or bronchopleural fistula\n* non-conventional ventilation\n* any patient on extra-corporeal membrane oxygenation (ECMO) support\n* less than 1 week post-operatively from cardiac surgery\n* the following cardiac diagnoses: Glenn or Fontan physiology, significant right to left shunt\n* Corrected Gestational Age \\\u003C 37 weeks\n* pregnancy","ALL","0 Years","18 Years",{"count":20,"type":21},60,"ESTIMATED","INTERVENTIONAL",[24],"NA","The goal of this clinical trial is to perform a PEEP titration protocol and use EIT to identify the optimal PEEP at which lung overdistention and collapse are most effectively balanced. The primary and secondary aims of the study are as follows:\n\nIdentify the difference between the optimal PEEP recommended by EIT metrics and the current guideline recommended approach to identifying optimal PEEP in PARDS. There will be a statistically significant difference in the recommended optimal PEEP identified using the EIT PEEP titration tool and that of the PEEP\u002FFiO2 grid recommendations.\n\nDetermine the difference in physiologic metrics between EIT optimal PEEP and the PEEP\u002FFiO2 recommended PEEP.\n\nParticipants will undergoing EIT monitoring while being subjected to PEEP titration protocol.",[27],"Pediatric Acute Respiratory Distress Syndrome",[29,30,31],"positive end-expiratory pressure","Electrical Impedance Tomography","respiratory distress","RECRUITING","2025-02-05",{"date":35,"type":36},"2025-02-07","ACTUAL",{"date":38,"type":36},"2024-12-10",{"date":40,"type":21},"2027-07-01",{"name":42,"class":43},"Children's Hospital Los Angeles","OTHER",1,{"id":46,"slug":47,"hasResults":11,"nctId":48,"briefTitle":49,"officialTitle":50,"acronym":51,"eligibilityCriteria":52,"healthyVolunteers":11,"sex":16,"minAge":53,"maxAge":18,"enrollmentInfo":54,"targetDuration":4,"studyType":22,"phases":56,"briefSummary":57,"conditions":58,"keywords":60,"overallStatus":32,"whyStopped":4,"lastUpdateSubmitDate":64,"lastUpdatePostDateStruct":65,"startDateStruct":67,"completionDateStruct":69,"leadSponsor":71,"locationsCount":73},"100544492","prone-position-during-ecmo-in-pediatric-patients-with-severe-ards-100544492","NCT06369584","Prone Position During ECMO in Pediatric Patients With Severe ARDS","Efficiency and Safety of Prone Position During Extracorporeal Membrane Oxygenation in Pediatric Patients With Severe Acute Respiratory Distress Syndrome: A Multi-center Randomized Study","PEPAD","Inclusion Criteria:\n\n* Severe PARDS and meets the criteria for ECMO support, has received ECMO support for less than 48 hours.\n* Informed consent obtained from the child's direct\u002Flegal guardian\n\nExclusion Criteria:\n\n1. Age \\\u003C 1 month or \\> 18 years old.\n2. ECMO initiated for more than 48 hours.\n3. Children who have undergone cardiopulmonary resuscitation (CPR) for more than 10 minutes before ECMO initiation without restoration of spontaneous circulation, or children undergoing extracorporeal cardiopulmonary resuscitation (ECPR).\n4. Presence of irreversible brain injury or intracranial hypertension.\n5. Children with irreversible lung disease awaiting lung transplantation.\n6. Children with abdominal trauma or postoperative acute respiratory distress syndrome (ARDS).\n7. Children in whom percutaneous cannulation cannot be performed due to unstable hemodynamics within the first 48 hours after ECMO support initiation.\n8. Other contraindications for performing percutaneous cannulation.\n9. Liver failure.\n10. Burn area \\>20% body surface area (BSA).","1 Month",{"count":55,"type":21},7,[24],"In 2023, the second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) updated the diagnostic and management guidelines for Pediatric Acute Respiratory Distress Syndrome (PARDS). The guidelines do not provide sufficient evidence-based recommendations on whether prone positioning ventilation is necessary for severe PARDS patients. However, the effectiveness of Extracorporeal Membrane Oxygenation (ECMO) in treating severe PARDS has been fluctuating around 70% according to recent data from Extracorporeal Life Support Organization (ELSO).\n\nIn 2018, the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) study group conducted a retrospective analysis and concluded that ECMO does not significantly improve survival rates for severe PARDS. However, this retrospective study mainly focused on data from North America, with significant variations in annual ECMO support cases among different centers, which may introduce bias. With advancements in ECMO technology and materials, ECMO has become safer and easier to operate. In recent years, pediatric ECMO support technology has rapidly grown in mainland China and is increasingly being widely used domestically to rescue more children promptly.\n\nECMO can also serve as a salvage measure for severely ARDS children who have failed conventional mechanical ventilation treatment. When optimizing ventilator parameters (titrating positive end expiratory pressure (PEEP) levels, neuromuscular blockers, prone positioning), strict fluid management alone cannot maintain satisfactory oxygenation (P\u002FF\\\u003C80mmHg or Oxygen Index (OI) \\>40 for over 4 hours or OI \\>20 for over 24 hours), initiating ECMO can achieve lung-protective ventilation strategies with ultra-low tidal volumes to minimize ventilator-associated lung injury.",[27,59],"Extracorporeal Membrane Oxygenation",[61,62,63],"Extracorporeal Membrane oxygenation","pediatric acute respiratory distress syndrome","prone position ventilation","2024-06-07",{"date":66,"type":36},"2024-06-10",{"date":68,"type":36},"2024-05-09",{"date":70,"type":21},"2025-07-01",{"name":72,"class":43},"Seventh Medical Center of PLA General Hospital",8]