Early Switch from Controlled to Assisted Ventilation

Launched by ERASMUS MEDICAL CENTER · May 29, 2024

Keywords

ClinConnect Summary

This clinical trial is looking at how changing the way patients receive breathing support can help those who are seriously ill with lung problems, specifically acute hypoxemic respiratory failure. In this study, adult patients who are on a ventilator will be switched from a method called "controlled ventilation" to "assisted ventilation" once their oxygen levels improve. The goal is to understand how this switch affects the stress on their lungs and to see if it can provide any clinical benefits.

To participate in this trial, patients need to be at least 18 years old and currently receiving mechanical ventilation through a tube in their throat, with low oxygen levels in their blood. They must have a legal representative who can give consent for them to join the study. However, those who are expected to need ventilation for less than 48 hours or have certain medical conditions may not be eligible. Throughout the trial, participants will be closely monitored to assess how their lungs respond to the change in ventilation. This study is currently recruiting participants, and it aims to gather important information that could improve care for patients with similar respiratory issues in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 18 years old
• • Written informed consent from a legal representative
• • Mechanical ventilation via an endotracheal tube
• • Acute hypoxemic respiratory failure with PaO2/FiO2 ratio \< 200 mmHg
• • Under continuous sedation with or without paralysis
• Exclusion Criteria:
• • Expected mechanical ventilation duration of \<48 hours
• • Pure chronic obstructive pulmonary disease exacerbation
• • Pre-existent respiratory muscle disease
• • Contraindication to EIT monitoring (as per clinical protocol, e.g. pacemaker, burns or thoracic wounds limiting electrode placement)
• • Contra-indications to oesophageal manometry (as per clinical protocol, e.g., recent oesophageal surgery, oesophageal varices, severe bleeding disorders)
• • Known pregnancy
• • Anticipating withdrawal of life support and/or shift to palliation as the goal of care

Trial Officials