Clinical Trials Logo

Clinical Trial Summary

The acute respiratory distress syndrome (ARDS) is common condition in critical ill patients affecting 7.2 people / 100,000 population / year and more than 7% of patients with invasive mechanical ventilation for more than 24 hours. ARDS carries a high hospital mortality of up to 48% and consumes large amounts of critical care resources. ARDS patients often present with severe hypoxemia that is refractory to conventional treatment and are thus evaluated for extracorporeal membrane oxygenation (ECMO). However, uncertainty regarding the appropriate indication for ECMO and clinical evidence for ECMO as a rescue treatment are still controversial. In 2012 Grasso and colleagues therefore presented a case series of influenza A (H1N1) ARDS patients describing the use of esophageal pressure measurements for individualized PEEP titration to achieve an end expiratory plateau pressure of the lung (PPLATL) of 25cm H2O. After performing the measurements in 14 patients, ventilator settings could be adjusted in half of these patients by increasing PEEP which resulted in an increase of oxygenation measures to an extend that criteria for extracorporeal support where no longer met and conventional treatment with invasive mechanical ventilation could be continued. However, uncertainty remains as to whether these results are generalizable to ARDS of any cause. In addition, increasing PEEP might impact on cardiac function and might therefore be associated with clinical important hemodynamic effects in these patients.

The investigators aim to evaluate hemodynamic changes in patients with severe ARDS in which an individualized PEEP treatment strategy can be employed. ARDS will be defined and stratified according to the Berlin ARDS definition. A naso-gastric probe capable of measuring esophageal pressure will be inserted directly after admission to the ICU as previously described. Invasive mechanical ventilation and oesophageal pressure measurements will be done using the GE Healthcare Carescape R860 ventilator. A pulmonary artery catheters (Edwards CCOcomb) will be inserted to evaluate the hemodynamic parameters of cardiac output, pulmonary artery pressures and left atrial pressures. Volumetric parameters will be measured using tanspulmonary thermodilution devices (Edwards EV1000). Cardiac function will be addressed in addition by the use of a predefined echocardiography protocol.


Clinical Trial Description

n/a


Study Design


Related Conditions & MeSH terms


NCT number NCT02617914
Study type Observational
Source RWTH Aachen University
Contact
Status Withdrawn
Phase N/A
Start date January 2016
Completion date January 2018

See also
  Status Clinical Trial Phase
Completed NCT02877524 - Trial to Study Intubation Rates of Non-invasive Ventilation Using Pressure Support Ventilation (PSV) Versus Adaptive Support Ventilation (ASV) Mode in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease N/A
Completed NCT04199273 - Assessment of Human Diaphragm Strength by Magnetic and Electric Stimulation After Ultrasonography Phrenic Nerve Tracking N/A
Completed NCT03955874 - Mechanical Ventilation Discontinuation Practices
Recruiting NCT06404294 - The External Diaphragm Pacemaker Assisted Extubation in Premature Infants With Invasive Mechanical Ventilation N/A
Not yet recruiting NCT06288724 - MOdifiable facTors to Improve VentilAtion ThErapy in ICU
Not yet recruiting NCT06217406 - Preemptive Treatment With Acyclovir in Intubated and Mechanically Ventilated Patients With Herpes (PTH2) N/A
Terminated NCT03460015 - Sevoflurane in Chronic Obstructive Pulmonary Disease Exacerbation N/A
Completed NCT04383730 - Inhaled Sedation in COVID-19-related Acute Respiratory Distress Syndrome (ISCA): an International Research Data Study in the Recent Context of Widespread Disease Resulting From the 2019 (SARS-CoV2) Coronavirus Pandemics (COVID-19)
Recruiting NCT05056961 - Effects of Large Tidal Volumes Despite Minimal Inspiratory Support in Spontaneously Ventilated Intubated Resuscitation Patients. Pathophysiological Exploratory Study. N/A
Completed NCT02380547 - Sonographic Evaluation of Diaphragmatic Function in Critical Care Patients With Use of Non Invasive Ventilation
Terminated NCT04222569 - Determination of the Optimal Spontaneous Breathing Trial During Weaning of Mechanical Ventilation N/A
Recruiting NCT05880953 - Parent-to-parent Coaching While Awaiting Hospital Discharge With a Child With a Ventilator N/A
Recruiting NCT05668637 - Evaluation and Further Development of an Artificial Intelligence-based Algorithm for Clinical Decision Support
Not yet recruiting NCT06261996 - Safety and Efficacy of Fospropofol vs Propofol During Invasive Mechanical Ventilation. N/A
Completed NCT02877498 - A Study to Compare Adaptive Support Ventilation vs. Volume Controlled Ventilation for Management of Respiratory Failure in Patients With Neuroparalytic Snake Envenomation N/A
Recruiting NCT05081973 - A Model for Predicting Extubation Success in Premature Babies