Acute Respiratory Distress Syndrome Clinical Trial
Official title:
Flow-flow ECCO2-R and 4 ml/kg Tidal Volume vs. 6 ml/kg Tidal Volume to Enhance Protection From Ventilator Induced Lung Injury in Acute Lung Injury (ELP)
The main objective of this randomized multicenter clinical trial is to test the hypothesis that further reduction of VT to 4mL/kg may enhance lung protection in patients with ARDS as compared to the conventional "ARDS-Net" ventilation. Control of PaCO2 in the ~4 ml/kg arm would be accomplished by LFPPV- ECCO2-R.
The trial will test the hypothesis that a VT of 4 ml/kg PBW combined with low flow CO2
removal improves outcome in patients with severe ARDS (PFs ≤ 200 and PEEP ≥ 10) compared to
ventilation with a VT of 6 ml/kg PBW. The study will accrue a maximum of 230 patients over
approximately 12-18 months.
PRIMARY END-POINT: Number of ventilator-free days (VFDs) during the 28 days immediately
after randomization
SECONDARY END-POINTS: 28 and 90-day all-cause mortality; number of ICU-free days during the
28 days immediately after randomization; cumulative incidence of: first episode of
refractory hypoxemia (during 28 days after randomization), use of rescue therapies, first
day that meet criteria for weaning, SOFA-free and severe adverse events.
Patients in CONTROL will be treated according to a modified, simplified version of The
ARDS-Network lung protective lower tidal volume. Patients in TREATMENT group will be treated
according to the ARDS-Net protocol modified (VT reduced by 1 ml/kg PBW at intervals ≤ 2
hours until VT = 4ml/kg PBW and the use of low-flow CO2 removal with a Plateau Pressure
Goal: ≤ 25 cm H2O).
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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