Acute Respiratory Distress Syndrome Clinical Trial
Official title:
EPVent 2- A Phase II Study of Mechanical Ventilation Directed by Transpulmonary Pressures (EPVent2)
This phase II multi-centered, randomized controlled trial of mechanical ventilation directed by esophageal pressure measurement will test the primary hypothesis that using a strategy of maintaining a minimal but positive transpulmonary pressure (Ptp = airway pressure minus pleural pressure) throughout the ventilatory cycle will lead to an improvement in patient survival.
This phase II prospective randomized controlled trial of ventilation directed by esophageal
pressure measurements will enroll 200 patients with moderate to severe ARDS by the Berlin
conference definition in several academic medical centers in North America. The control group
will be ventilated using an alternative high-PEEP strategy with PEEP and FiO2 set using to an
empiric table.
Plasma samples will be obtained at enrollment and days 3 and 7 and assessed for a variety of
lung injury biomarkers to better assess the association between our intervention and the
inflammation associated with mechanical ventilation and the development of ARDS. Hospital
survivors will undergo a brief follow up phone survey to assess survival, functional status
(Barthel Index), health-related QOL (Short Form 12), and frailty (VES) twelve months after
enrollment.
The study length will be six years with a six month start-up period followed by a planned 50
month enrollment and twelve month follow-up.
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