Clinical Decision Support Tool in PARDS Pilot Study

Launched by CHILDREN'S HOSPITAL LOS ANGELES · Aug 22, 2019

Keywords

ClinConnect Summary

This clinical trial, called the Clinical Decision Support Tool in PARDS Pilot Study, is looking at how a special tool can help doctors make better decisions about mechanical ventilation for children with a serious lung condition known as Pediatric Acute Respiratory Distress Syndrome (PARDS). Previous studies in adults have shown that using better management techniques can save lives and reduce the time patients spend on ventilators. This trial aims to see if a decision-making tool, based on the best available research, can be effectively used in children's hospitals to improve care for young patients needing mechanical ventilation.

To be eligible for this study, children must be over one month old and under 18, currently on mechanical ventilation for lung issues, and expected to need this support for more than 72 hours. The researchers hope to enroll up to 180 children in various pediatric intensive care units (PICUs). Participants will receive care guided by the decision support tool, and the study will monitor how well it works in practice. If successful, this tool could lead to a larger study that aims to reduce the time children spend on mechanical ventilation, which could ultimately improve their recovery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Children \> 1 month of age and \>44 weeks gestation and ≤ 18 years of age AND
• • Supported on mechanical ventilation with pulmonary parenchymal disease (i.e. Pediatric Acute Respiratory Distress Syndrome (PARDS)) with Oxygen Saturation Index (OSI) ≥ 5) or Oxygenation Index (OI) ≥ 4 AND
• • Who are within 72 hours of initiation of invasive mechanical ventilation AND
• • Who are anticipated to require \>72 hours mechanical ventilation.
• Exclusion Criteria:
• • Conditions on enrollment that preclude conventional methods of weaning (i.e., status asthmaticus, severe lower airway obstruction, bronchiolitis, critical airway, Extra Corporeal Life Support (ECLS), intubation for Upper Airway Obstruction, Do Not Resuscitate orders, severe chronic respiratory failure, spinal cord injury above lumbar region, cyanotic heart disease (unrepaired or palliated)) OR
• • Conditions precluding the use of permissive hypercapnia or hypoxemia (i.e. intracranial hypertension, severe pulmonary hypertension)
• • Primary Attending physician refuses to enroll the patient