Clinical trial

Bedside Lung Ultrasound to Monitor Lung Recruitment in Obese Patients

Opening soon · Not applicable · 0 countries · Registry ID NCT07542093

Opening soonNot applicableObservational

What this study is about

Patients with morbid obesity who require a breathing machine (mechanical ventilator) in the Intensive Care Unit (ICU) frequently experience partial lung collapse. This happens because the extra weight of the chest and abdomen presses on the lungs, reducing their capacity and making it difficult to maintain adequate oxygen levels. To address this, doctors often perform a standard lung recruitment maneuver, which involves temporarily increasing the air pressure from the ventilator to gently pop open the collapsed lung areas. However, standard bedside monitoring tools make it difficult to see exactly how well the different regions of the lungs are reopening. This prospective observational study aims to evaluate the use of Bedside Lung Ultrasound (LUS), which is a safe, radiation-free imaging tool, to monitor how well the lungs respond to these maneuvers in real-time. During the study, researchers will use a standardized 12-zone ultrasound scan to examine the lungs of mechanically ventilated adult patients (BMI ≥ 33 kg/m²) before, during, and after a step-by-step lung recruitment maneuver. By calculating a "Total Lung Ultrasound Score," the medical team can directly visualize and measure the transition from collapsed tissue to normal, aerated lung tissue. Furthermore, the ultrasound will be used during a step-down pressure phase to help identify the patient's "optimal PEEP" (Positive End-Expiratory Pressure), which is the exact customized pressure needed to keep the lungs open after the maneuver is complete, thereby improving oxygenation and minimizing the risk of lung injury.

A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.

Basic eligibility

Age18 Years to Not listed

SexAll

Healthy volunteersNot listed

ConditionMorbid Obesity, Obesity, Respiratory Failure, Atelectasis, Ventilator-Induced Lung Injury (VILI)

Full registry criteria

Inclusion Criteria: * Adult patients aged \>18 years * BMI ≥ 33 kg/m² (morbid obesity) * Intubated and receiving invasive mechanical ventilation for any indication (elective surgery, respiratory failure, post-operative ICU admission) * Expected duration of mechanical ventilation ≥ 6 hours * Hemodynamically stable at enrollment: Mean Arterial Pressure (MAP) ≥ 65 mmHg without escalating vasopressor support * SpO₂ ≥ 85% on current ventilator settings * Written informed consent obtained from patient or legal guardian Exclusion Criteria: * Known or suspected pneumothorax or bullous emphysema (contraindication to recruitment maneuvers) * Severe hemodynamic instability: MAP \< 60 mmHg or requiring high-dose vasopressors (norepinephrine \> 0.3 mcg/kg/min) * Active bronchopleural fistula * Recent thoracic or cardiac surgery (within 48 hours) where high airway pressures are contraindicated * Raised intracranial pressure (ICP) or known severe traumatic brain injury * Confirmed ARDS with PaO₂/FiO₂ ratio \< 100 mmHg (severe ARDS, where recruitment strategy differs significantly) * Chest wall deformity or subcutaneous emphysema that precludes reliable lung ultrasound assessment * Refusal of consent

Treatments and study arms

The registry does not list a named intervention.

Primary outcomes

Change in Total Lung Ultrasound Score (LUS)Baseline (immediately before the recruitment maneuver) to 15-20 minutes after establishing optimal PEEP

The Total Lung Ultrasound Score (LUS) assesses regional lung aeration using a 12-zone scanning protocol. Each of the 12 zones is scored from 0 (normal aeration) to 3 (complete collapse/tissue-like consolidation). The total score is the sum of all 12 zones, ranging from 0 to 36, where a higher score indicates worse lung aeration. This measure evaluates the quantitative change in real-time regional re-aeration resulting from the lung recruitment maneuver.

Study locations

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No public site location was included in this record. Check the original registry for updates.