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Acute Lung Injury clinical trials

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NCT ID: NCT06322758 Not yet recruiting - Clinical trials for Acute Respiratory Distress Syndrome ARDS

Driving Pressure-guided Tidal Volume Ventilation in the Acute Respiratory Distress Syndrome

DRIVENT
Start date: September 1, 2024
Phase: N/A
Study type: Interventional

Acute respiratory distress syndrome (ARDS) is associated with high mortality, some of which can be attributed to ventilator-induced lung injury (VILI) when artificial ventilation is not customized to the severity of lung injury. As ARDS is characterized by a decrease in aerated lung volume, reducing tidal volume (VT) from 12 to 6 mL/kg of predicted body weight (PBW) was shown to improve survival more than 20 years ago. Since then, the VT has been normalized to the PBW, meaning to the theoretical lung size (before the disease), rather than tailored to the severity of lung injury, i.e., to the size of aerated lung volume. During ARDS, the aerated lung volume is correlated to the respiratory system compliance (Crs). The driving pressure (ΔP), defined as the difference between the plateau pressure and the positive end expiratory pressure, represents the ratio between the VT and the Crs. Therefore, the ΔP normalizes the VT to a surrogate of the aerated lung available for ventilation of the diseased lung, rather than to the theoretical lung size of the healthy lung, and thus represents more accurately the actual strain applied to the lungs. In a post hoc analysis of 9 randomized controlled trials, Amato et al. found that higher ΔP was a better predictor of mortality than higher VT, with an increased risk of death when the ΔP > 14 cm H2O. These findings have been confirmed in subsequent meta-analysis and large-scale observational data. In a prospective study including 50 patients, the investigators showed that a ΔPguided ventilation strategy targeting a ΔP between 12 and 14 cm H2O significantly reduced the mechanical power, a surrogate for the risk of VILI, compared to a conventional PBW-guided ventilation. In the present study, the investigators hypothesize that the physiological individualization of ventilation (ΔP-guided VT) may improve the outcome of patients with ARDS compared to traditional anthropometrical adjustment (PBW-guided VT)

NCT ID: NCT06308926 Not yet recruiting - Clinical trials for Acute Respiratory Distress Syndrome

MRG-001 as an Immunoregulatory and Regenerative Therapy for ARDS Patients

SUMMIT
Start date: July 1, 2024
Phase: Phase 2
Study type: Interventional

This is a phase IIa, dose-ranging, proof-of-concept study of MRG-001 in patients with ARDS. The aim is to determine the safety and preliminary efficacy of MRG-001 across two dose ranges.

NCT ID: NCT06290310 Not yet recruiting - Acute Lung Injury Clinical Trials

Assessment of Patient-ventilator Asynchrony by Electric Impedance Tomography

PAVELA
Start date: April 12, 2024
Phase:
Study type: Observational

Patient-ventilator asynchrony (PVA) has deleterious effects on the lungs. PVA can lead to acute lung injury and worsening hypoxemia through biotrauma. Little is known about how PVA affects lung aeration estimated by electric impedance tomography (EIT). Artificial intelligence can promote the detection of PVA and with its help, EIT measurements can be correlated to asynchrony.

NCT ID: NCT06278675 Not yet recruiting - Sepsis Clinical Trials

Multiple Study of Electroaccpuncture in ARDS

Start date: April 1, 2024
Phase: N/A
Study type: Interventional

In order to clarify the clinical efficacy of electroacupuncture on inhibiting systemic inflammatory response, improving respiratory mechanics parameters and prognosis in patients with sepsis-related ARDS.

NCT ID: NCT06276569 Not yet recruiting - Cardiac Disease Clinical Trials

Efficacy and Safety of Sivelestat in Preventing Postoperative Acute Respiratory Distress Syndrome After Cardiac Surgery :a Single Centre Random Control Trial.

Start date: February 18, 2024
Phase: Phase 3
Study type: Interventional

The aim of this study is to assess the effectiveness and safety of sivelestat sodium in preventing acute respiratory distress syndrome (ARDS) following cardiac surgery, with the objective of providing evidence-based support for its clinical application.

NCT ID: NCT06254313 Not yet recruiting - Influenza Clinical Trials

The Role of Cxcr4Hi neutrOPhils in InflueNza

CHOPIN
Start date: September 2024
Phase:
Study type: Observational

Influenza is still responsible for more than 650,000 deaths per year worldwide and no major improvements in patients' care has been made despite 50 years of research. Especially, there is no therapeutic strategy targeting the dysregulated host response. CXCR4-expressing neutrophils seem to be involved in the rupture of host resistance. The aim of this study is thus to compare the percentage of blood CXCR4-expressing neutrophils between influenza survivors and non-survivors.

NCT ID: NCT06250348 Not yet recruiting - ARDS, Human Clinical Trials

Exhaled Nitric Oxide : Biomarker of Acute Respiratory Distress Syndrome

ENOBARDS
Start date: February 2024
Phase:
Study type: Observational

The aim of the study is to see if endogenous exhaled Nitric Oxyde (eNO) concentrations measured are significantly higher in ARDS patients admitted in ICU ; compared to control subjects in good health with no lung disease or global inflammation, operated under general anesthesia (i.e. intubated and ventilated) for thyroid or parathyroid.

NCT ID: NCT06249633 Not yet recruiting - Clinical trials for Pulmonary Hypertension

Inhaled Nitric Oxide for ARDS-related Pulmonary Hypertension

Start date: February 2024
Phase: Early Phase 1
Study type: Interventional

Open-label pilot study of early inhaled nitric oxide (iNO) for patients developing de novo pulmonary hypertension during Acute Respiratory Distress Syndrome (ARDS.) The study aims to determine whether iNO has possible hemodynamic and clinical benefits when given early in the course of ARDS to patients with evidence of elevated pulmonary artery pressure.

NCT ID: NCT06233448 Not yet recruiting - Clinical trials for Acute Respiratory Distress Syndrome

Thorathic Fluid Content as an Early Predictor of Weaning From Mechanical Ventilation in Acute Respiratory Distress Syndrome

Start date: February 2024
Phase:
Study type: Observational [Patient Registry]

Thorathic fluid content measurement using indirect cardiometry is required for prediction of Weaning from mechanical ventilation in cases of acute respiratory distress syndrome and its value in sucsess Weaning

NCT ID: NCT06215209 Not yet recruiting - Clinical trials for Acute Respiratory Distress Syndrome

Effect of PP in Patients With Ultra-low VT

Start date: February 1, 2024
Phase:
Study type: Observational

Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome with similar clinicopathological feathers caused by different etiologies. Respiratory supportive strategies is the main ARDS management, and the guidelines recommend low tidal volume to improve clinical outcomes. To be note, overdistension can still occur even if using a tidal volume as low as 6 ml/kg, given the heterogeneous nature of the syndrome. Therefore, adjusting tidal volume level to less than 6ml/kg may reduce ventilator-induced lung injury (VILI) and thus improve outcomes, especially in patients with severe lung injury. Prone position is also an important management in severe ARDS. Prone position can improve ventilation-perfusion (V/Q) matching and reduce the risk of VILI by recruiting dorsal collapsed alveoli. Meanwhile, prone position has also been shown to improve hemodynamics. Recent studies have showed that prone position did not reduce duration of venovenous extracorporeal membrane oxygenation (VV-ECMO) and 90-day mortality in patients with ARDS who receive VV-ECMO with ultra-low tidal volume ventilation. Therefore, the effect of PP on ventilation and lung blood flow in ARDS patients treated with VV-ECMO wiht ultra-low tidal volume ventilation remains unclear.