Acute Respiratory Distress Syndrome Clinical Trial
Official title:
Reducing High Respiratory Drive to Facilitate Supported Ventilation in ARDS Patients: a Pilot Study
Acute respiratory distress syndrome (ARDS) is characterized by acute bilateral pulmonary
infiltrates and impairment of oxygen uptake. For example, pneumonia can cause the
development of ARDS. Despite modern intensive care treatment, mortality in ARDS patients
remains high (40%). Invasive mechanical ventilation (MV) is the mainstay of ARDS treatment.
Controlled MV is the conventional ventilation strategy to ensure lung protective ventilation
(low tidal volumes) and recovery of the lungs. However, among disadvantages of controlled MV
are the development of respiratory muscle atrophy (due to disuse) and the need for high dose
sedatives to prevent patient-ventilator asynchrony. The use of high doses of sedatives and
respiratory muscle weakness are associated with increased morbidity, worse clinical outcomes
and prolonged MV.
Besides controlled MV, a patient can be ventilated with supported ventilation. Supported MV
decreases the likelihood to develop muscle atrophy, improves oxygenation and hemodynamics,
and lowers consumption of sedatives. However potential disadvantages of supported
ventilation include generation of too high tidal volumes, especially in patients with high
respiratory drive. A previous study in healthy subjects has shown that titration of
neuromuscular blocking agent (NMBA) can decrease activity of inspiratory muscles, while
maintaining adequate ventilation. It is hypothesized that low dose NMBA may enable supported
MV with adequate tidal volumes, in patients with high respiratory drive.
n/a
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
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