Acute Respiratory Distress Syndrome Clinical Trial
Official title:
Safety and Efficacy of Combined Extracorporeal CO2 Removal and Renal Replacement Therapy in Patients With the Acute Respiratory Distress Syndrome and Acute Renal Failure
In patients presenting with the acute respiratory distress syndrome (ARDS), mechanical
ventilation with low tidal volume (6 ml/kg predicted body weight) is the current gold
standard for supportive care. However, despite a relative low tidal volume, approximatively
one third of patients will experienced tidal hyperinflation, a phenomenon known to induce
pulmonary and systemic inflammatory response. A further reduction of the tidal volume to 4
ml/kg (PBW) will prevent pulmonary area from tidal hyperinflation. As a result, hypercarbia
and respiratory acidosis are commonly observed with such very low tidal ventilation. Extra
corporeal CO2 removal is one of a mean to normalize arterial CO2 tension.
Patients with ARDS also frequently develop acute renal failure which may required Renal
Replacement Therapy. Some data suggests that starting early the RRT may favor outcome.
The investigators hypothesized that a strategy combining ECCOR and RRT early in the course
of patients presenting ARDS and acute renal failure will allow the tidal volume to be
further reduced, providing lung protection, while avoiding the arterial CO2 tension to be
increased.
For this purpose, the investigators sought to evaluate the safety and efficacy of adding a
membranel oxygenator within an hemofiltration circuit, either upstream or downstream of the
hemofilter.
n/a
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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