Acute Respiratory Distress Syndrome Clinical Trial
Official title:
A Multi-centre Randomised Controlled Trial of an Open Lung Strategy Including Permissive Hypercapnia, Alveolar Recruitment and Low Airway Pressure in Patients With Acute Respiratory Distress Syndrome.
Some people develop the condition called acute respiratory distress syndrome (ARDS). This is
a condition where the lungs have become injured from one of a number of various causes, and
do not work as they normally do to provide oxygen and remove carbon dioxide from the body.
This can lead to a reduced amount of oxygen in the patient's bloodstream. Patients with ARDS
are admitted to the intensive care unit (ICU) and need help with their breathing by being
connected to a ventilator (breathing machine). ARDS can lead to injury in other organs of the
body causing other problems but also death.
Over the past few years, reducing the size of each breath delivered by the ventilator in
conjunction with the use of an occasional sustained deep breath called a "recruitment
manoeuvre" have been used to try to prevent further damage to the lungs in people with ARDS.
This ventilator strategy (termed the PHARLAP strategy) has been shown in a small research
study to have some beneficial effects without causing any obvious harm, when compared to a
current best practice ventilator strategy. The main beneficial effects of the PHARLAP
strategy were to increase the amount of oxygen in the blood and to reduce markers of
inflammation (the body reacting to a disease process) in the body. This study was too small
to make a strong conclusion, so this study will be much larger and will assess whether
patients who have developed ARDS are better off when we use the PHARLAP strategy. Three
hundred and forty patients will be enrolled into this study in multiple ICUs across Australia
and New Zealand.
The study hypothesis is that the PHARLAP strategy group will have a higher number of
ventilator free days at day 28 than the control group.
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