Mechanical Ventilation Clinical Trial
Official title:
Personalized Mechanical Ventilation Guided by UltraSound in Patients With Acute Respiratory Distress Syndrome
Rationale Acute respiratory distress syndrome (ARDS) is a frequent cause of hypoxemic respiratory failure with a mortality rate of approximately 30%. The identification of ARDS phenotypes, based on focal or non-focal lung morphology, can be helpful to better target mechanical ventilation strategies of individual patients. Lung ultrasound (LUS) is a non-invasive tool that can accurately distinguish 'focal' from 'non-focal' lung morphology. The investigators hypothesize that LUS-guided personalized mechanical ventilation in ARDS patients will lead to a reduction in 90-day mortality compared to conventional mechanical ventilation.
Status | Recruiting |
Enrollment | 538 |
Est. completion date | November 1, 2026 |
Est. primary completion date | August 1, 2026 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 100 Years |
Eligibility | Inclusion Criteria: - Admitted to a participating ICU, - invasively ventilated and - fulfil the Berlin criteria for moderate or severe ARDS. Exclusion Criteria: - Age under 18, - participation in other interventional studies with conflicting endpoints, - conditions in which LUS is not feasible or possible (e.g. subcutaneous emphysema, morbid obesity or wounds), - mechanical ventilation for longer than 7 consecutive days in the past 30 days, - history of ARDS in the previous month, - body-mass index higher than 40 kg/m², - intracranial hypertension, - broncho-pleural fistula, - chronic respiratory diseases requiring long-term oxygen therapy or respiratory support, - pulmonary fibrosis with a vital capacity < 50% (severe or very severe), - previously randomized in the PEGASUS study - ECMO - patients who are moribund or facing end of life and - no informed consent. |
Country | Name | City | State |
---|---|---|---|
Belgium | Chu-Brugmann | Bruxelles | |
Denmark | Bispebjerg Hospital | Copenhagen | |
Denmark | Nordsjaellands Hospital | Hillerød | |
Greece | Evaggelismos Hospital | Athens | |
Ireland | Galway University Hospitals | Galway | |
Italy | Ospedale Generale Regionale F. Miulli | Acquaviva Delle Fonti | Bari |
Italy | Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari | Bari | |
Netherlands | Amsterdam UMC, location AMC | Amsterdam | Noord-Holland |
Netherlands | Amsterdam UMC, location VUmc | Amsterdam | Noord-Holland |
Poland | Centralny Szpital Kliniczny MSWiA | Warsaw |
Lead Sponsor | Collaborator |
---|---|
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) |
Belgium, Denmark, Greece, Ireland, Italy, Netherlands, Poland,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | All-cause mortality | Any death during ICU- or hospital-stay at day 90 | 90 days after inclusion | |
Secondary | All-cause mortality | Any death during ICU- or hospital-stay at day 28 | 28 days after inclusion | |
Secondary | Ventilator free days | Duration of ventilation in survivors | 28 days after inclusion | |
Secondary | ICU length of stay | Length of stay in the intensive care unit | 90 days after inclusion | |
Secondary | ICU mortality | Mortality in the ICU | 90 days after inclusion | |
Secondary | Hospital length of stay | Length of stay in the hospital | 90 days after inclusion | |
Secondary | Hospital mortality | Mortality in the hospital | 90 days after inclusion | |
Secondary | Number of patients with Complications | Ventilator associated pneumonia and pneumothorax | 90 days after inclusion | |
Secondary | Number of patients with Adjunctive therapies | Extracorporeal membrane oxygenation (ECMO), recruitment, prone position | 90 days after inclusion | |
Secondary | Number of patients with Rescue therapies | Inhaled vasodilators, airway pressure release ventilation | 90 days after inclusion |
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