740
Participants
Start Date
November 23, 2020
Primary Completion Date
November 30, 2025
Study Completion Date
March 31, 2026
Respiratory Mechanics
"Different maneuvers based on respiratory mechanics will be assessed at the bedside and will be used to individualize ventilator parameters. Recruitability will be assessed with a one breath decremental PEEP maneuver, and search for airway closure with a low-flow pressure volume or pressure-time curve. If the patient has airway closure, the minimal PEEP will be set at the airway opening pressure to avoid closure. If the patient is considered recruitable, the goal is to set PEEP at or above 15cmH20 to maximize alveolar recruitment, until the plateau pressure reaches the safety limit. Volume control ventilation at 6ml·kg-1 will be used.~Once spontaneous breathing has started, the occlusion pressure (P0.1) will be maintained within targets."
Standard Ventilation Strategy
Patients randomized to the control arm will receive standard care. The PEEP is adjusted for oxygenation based on a PEEP-FiO2 table, either the low PEEP-FiO2 or the high PEEP-FiO2 table. Volume targeted ventilation with initial VT 6 mL·kg-1 and Plateau pressure at 30 cmH2O or below, targeting PaO2 60-80 or SpO2 90-95%, adjusted as per the protocol. Pressure-support ventilation is at physician's discretion, but recommended when FiO2 \<60%, and is titrated VT 6-8 mL·kg-1.
RECRUITING
New York University Grossman School of Medicine, New York
RECRUITING
Centro de Educación Médica e Investigaciones Clínicas Dr Norberto Quirno (CEMIC), Buenos Aires
RECRUITING
Complejo Médico Policía Federal Argentina Churruca Visca, Buenos Aires
RECRUITING
Hospital Británico de Buenos Aires, Buenos Aires
RECRUITING
Sanatorio Anchorena Recoleta, Buenos Aires
RECRUITING
Sanatorio Mater Dei, Buenos Aires
RECRUITING
Sanatorio Anchorena San Martín, San Martín
RECRUITING
St. Michael's Hospital, Toronto
RECRUITING
Toronto General Hospital, Toronto
RECRUITING
Toronto Western Hospital, Toronto
RECRUITING
Pontificia Universidad Católica de Chile, Santiago
RECRUITING
CHU Amiens-Picardie, Amiens
RECRUITING
Centre hospitalier universitaire d'Angers, Angers
RECRUITING
CH Victor Dupouy, Argenteuil
RECRUITING
CH de Beauvais, Beauvais
RECRUITING
CHU Bordeaux - Haut Leveque, Bordeaux
RECRUITING
Hopital de la Cavale Blanche - CHRU Brest, Brest
RECRUITING
CH de Cholet, Cholet
RECRUITING
Hopital Intercommunal de Creteil, Créteil
RECRUITING
CHU Grenoble-Alpes, Grenoble
RECRUITING
Hopital Roger Salengro - CHU Lille, Lille
RECRUITING
Groupe Hospitalier de la Region de Mulhouse et Sud Alsace, Mulhouse
RECRUITING
Hopital de l'Archet 1 - CHU de Nice, Nice
RECRUITING
Hopital Europeen Georges-Pompidou, Paris
RECRUITING
CHU de Poitiers - La Miletrie, Poitiers
RECRUITING
CH Bretagne Atlantique Vannes-Auray, Vannes
RECRUITING
HIA Robert Picque, Villenave-d'Ornon
RECRUITING
Arcispedale Sant'Anna, Ferrara
RECRUITING
University of Foggia, Foggia
RECRUITING
Policlinico Universitario Agostino Gemelli IRCCS, Rome
RECRUITING
L'Hospital de la Santa Creu i Sant Pau, Barcelona
RECRUITING
Vall d'Hebron University Hospital, Barcelona
Collaborators (1)
Canadian Institutes of Health Research (CIHR)
OTHER_GOV
University of Toronto
OTHER
Applied Health Research Centre
OTHER
Unity Health Toronto
OTHER