Acute Respiratory Distress Syndrome Clinical Trial
Official title:
A Prospective, Multi-center, Open-label and Double-blind, Standard-controlled, Non-inferiority, Diagnostic Study of Lung Ultrasound for Management of Mechanical Ventilation in Neonatal Acute Respiratory Distress Syndrome
The purpose of this study was to evaluate the availability and diagnostic accuracy of point-of-care bedside lung ultrasound examination in management of mechanical ventilation in neonatal acute respiratory distress syndrome.
Neonatal acute respiratory distress syndrome (ARDS) is a critical condition requiring
dynamic evaluation and interventions. Point-of-care bedside lung ultrasound examination
(PoC-BLUE) is a noninvasive, readily available imaging modality that can complement physical
and clinical evaluation.
At any time, most neonates and infants with ARDS in medical intensive care units (ICUs)
require mechanical ventilation, making it one of the most frequently used critical care
technologies. However, difficulties with regard to the accurate diagnosis of ARDS before
administration of mechanical ventilation, dynamic monitoring of treatment effects during
administration of mechanical ventilation, and decision-making of timing in weaning from
mechanical ventilation, are often encountered in the majority neonates and infants who
require mechanical ventilation.
Hence, techniques that expedite and advance the knowledge of the administration of
mechanical ventilation should have an important clinical significance in the diagnosis,
treatment and prognosis of ARDS.
Preliminary researches have suggested that BLUE has a high diagnostic accuracy in patients
with acute respiratory failure, and has the potential to quantify the rate and degree of
diaphragm thinning during mechanical ventilation, which may be useful to predict extubation
success or failure during either spontaneous breathing (SB) or pressure support (PS) trials.
Unfortunately, few studies focus on the availability of PoC-BLUE in management of mechanical
ventilation in neonatal acute respiratory distress syndrome. Also, they call into question
the possible association of the demographic and clinical confounders with the diagnostic
accuracy of PoC-BLUE for diagnosis, monitoring and prognosis of ARDS in the whole process of
mechanical ventilation.
Given that a considerable need for a timely and dynamic diagnosis of severe condition and
therapy evaluation during mechanical ventilation has been triggered to integrate the
currently available bulk of knowledge and information, the objective of this study is to
investigate the availability and diagnostic accuracy of PoC-BLUE Plus protocol in management
of mechanical ventilation in ARDS.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Diagnostic
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