Precision Ventilation vs Standard Care for Acute Respiratory Distress Syndrome

PHASE3RecruitingINTERVENTIONAL
Enrollment

1,100

Participants

Timeline

Start Date

June 24, 2024

Primary Completion Date

October 1, 2029

Study Completion Date

August 31, 2030

Conditions
Acute Respiratory Distress SyndromeRespiratory Failure
Interventions
OTHER

Precision ventilation

The intervention arm prioritizes mitigation of ventilator-induced-lung-injury by individualizing support to patient-specific mechanics in an integrated approach to limit overdistension and atelectrauma. This is accomplished in this arm by titration of tidal volume to limitation of driving pressure at 12 centimeters of water (cmH2O) or less and using esophageal manometry to titrate PEEP to a transpulmonary pressure of 0 cmH2O with adjustments in respiratory rate to allow for permissive hypercapnia and FiO2 adjustments to assure adequate oxygenation.

OTHER

Guided usual care ventilation

The comparison arm allows clinician discretion when titrating PEEP and tidal volume, while setting general targets for allowable PEEP/FiO2 combinations, target range for SpO2, and target range for tidal volume. This arm applies routine best-practice guidelines. This includes maintenance of tidal volumes of 6-8 cc/kg of ideal body weight, limiting plateau pressures to 30 cmH2O or less and application of PEEP-FiO2 combinations which include a wide range of typical usual care with esophageal manometry only for data collection and not clinical adjustment.

Trial Locations (24)

10016

RECRUITING

New York City Health + Hospitals/ Bellevue, New York

10461

RECRUITING

Albert Einstein College of Medicine/Montefiore Medical Center, The Bronx

27157

RECRUITING

Atrium Health Wake Forest Baptist, Winston-Salem

27710

NOT_YET_RECRUITING

Duke University Medical Center, Durham

43210

RECRUITING

Ohio State University Wexner Medical Center, Columbus

44195

RECRUITING

Cleveland Clinic Foundation, Cleveland

45267

RECRUITING

University of Cincinnati, Cincinnati

48109

RECRUITING

University of Michigan, Ann Arbor

60637

RECRUITING

University of Chicago, Chicago

77030

RECRUITING

Baylor College of Medicine / St. Luke's Medical Center, Houston

84107

RECRUITING

Intermountain Health, Murray

84132

RECRUITING

University of Utah, Salt Lake City

85724

RECRUITING

University of Arizona, Tucson

90024

RECRUITING

University of California, Los Angeles Medical Center, Los Angeles

90048

RECRUITING

Cedar-Sinai Medical Center, Los Angeles

92093

NOT_YET_RECRUITING

University of California, San Diego, La Jolla

94143

RECRUITING

University of California, San Francisco, San Franciso

97239

RECRUITING

Oregon Health & Science University, Portland

98104

RECRUITING

University of Washingont/Harborview Medical Center, Seattle

02111

RECRUITING

Tufts Medical Center, Boston

02114

RECRUITING

Massachusetts General Hospital, Boston

RECRUITING

NYU Lagone Health, New York

02115

NOT_YET_RECRUITING

Brigham and Women's Hospital, Boston

02215

RECRUITING

Beth Israel Deaconess Medical Center, Boston

All Listed Sponsors
collaborator

NYU Langone Health

OTHER

collaborator

Massachusetts General Hospital

OTHER

collaborator

National Heart, Lung, and Blood Institute (NHLBI)

NIH

lead

Beth Israel Deaconess Medical Center

OTHER