Acute Respiratory Distress Syndrome (ARDS) Clinical Trial
Official title:
A Phase I Trial of Inhaled Carbon Monoxide for the Treatment of Sepsis-Induced Acute Respiratory Distress Syndrome (ARDS)
The purpose of this study is to assess the safety of inhaled carbon monoxide (iCO) in intubated patients with sepsis-induced ARDS.
The acute respiratory distress syndrome (ARDS) is a syndrome of severe acute lung
inflammation and hypoxemic respiratory failure with an incidence of 180,000 cases annually in
the U.S.Despite decades of research and recent advances in lung protective ventilator
strategies, morbidity and mortality remain unacceptably high. Furthermore, no specific
effective pharmacologic therapies currently exist. The lack of specific effective therapies
for sepsis-related ARDS indicates a need for new treatments that target novel pathways.
Carbon monoxide (CO) represents a novel therapeutic modality in ARDS based on data obtained
in experimental models of ARDS and sepsis over the past decade.
CO has been shown to be protective in experimental models of Acute Lung Injury (ALI),
including hyperoxia and endotoxin exposure, bleomycin, ischemia/reperfusion, and
ventilator-induced lung injury (VILI). At low doses, CO has been shown to confer tissue
protective effects in these ALI models. In addition, CO has been shown to decrease
inflammation, enhance phagocytosis, and improve mortality in models of sepsis including
endotoxemia, hemorrhagic shock, and cecal ligation and puncture (CLP). CO has also been shown
to have beneficial therapeutic effects in pre-clinical models of disease including pulmonary
hypertension, vascular injury, and transplantation. Furthermore, multiple human studies have
demonstrated that experimental administration of several different concentrations of CO is
well tolerated and that low dose inhaled CO can be safely administered to subjects in a
controlled research environment.
The purpose of this study is to assess the safety of inhaled CO therapy in mechanically
ventilated patients with sepsis-induced ARDS.
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