Respiratory Distress Syndrome, Adult Clinical Trial
Official title:
Prospective, Randomized, Multicenter Trial of Aerosolized Albuterol Versus Placebo in Acute Lung Injury
Acute Respiratory Distress Syndrome (ARDS) and a lesser condition that occurs prior to ARDS, Acute Lung Injury (ALI), are medical conditions that occur when there is severe inflammation and increased fluids (edema) in both lungs, making it hard for the lungs to function properly. Patients with these conditions require treatment that includes the use of a breathing machine (ventilator). The purpose of this study is to find out whether giving albuterol (a drug commonly used in asthmatics) or not giving albuterol to patients with ALI or ARDS makes a difference in how long it takes for a patient to be able to breath without the ventilator.
Aerosolized beta-2 agonist therapy is anticipated to diminish the formation of lung edema,
enhance clearance of lung edema and decrease pulmonary inflammation in patients with acute
lung injury. Because beta-2 agonists have been shown to reduce permeability induced lung
injury, it is anticipated that the severity of lung injury will be reduced by aerosolized
beta-2 agonist therapy. The therapy may work by enhancing resolution of pulmonary edema by
upregulating alveolar epithelial fluid transport mechanisms that will in turn enhance the
clearance of alveolar edema. A reduction in the severity of lung injury and the quantity of
alveolar edema should result in earlier extubation and more ventilator free days, improved
pulmonary oxygen uptake, and improved lung compliance.
Study design: phase II/III prospective, randomized double-blind, placebo controlled trial.
- In Phase II, patients will be treated with aerosolized albuterol 5.0 mg vs. normal
saline (n=40-50)administered every 4 hours for 10 days following randomization or until
24 hours following extubation, whichever occurs first. The protocol stipulates that the
5.0 mg dose will be reduced to 2.5 mg if patients exceed defined heart rate limits.
- In Phase III, the 5.0 mg dose will be used unless there is evidence that this dose has
an unacceptable safety profile or dose reductions for tachycardia occur in a large
fraction of patients. In that case, a lower dose of 2.5 mg will be used.
- Patients will be followed for 90 days or until discharge from the hospital to home with
unassisted breathing whichever occurs first.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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