BEST (Burn Center Evaluation of Standard Therapies) Ventilator Mode Study-
BEST (Burn Center Evaluation of Standard Therapies) Ventilator Mode Study: A Prospective Randomized Controlled Trial
The purpose of this study is to compare High Frequency Pressure Ventilation (HFPV) to conventional mechanical ventilation.
Hypothesis: Patients placed on HFPV will have significantly higher number of ventilator-free days compared to patients placed on a conventional volume mode.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Texas
-
Fort Sam Houston, Texas, United States, 78234
- United States Army Institute of Surgical Research
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients who are deemed to require ventilatory support for more than 24 hours from the time of screening.
Exclusion Criteria:
- Anticipated extubation within 24 hours of screening
- Patients who are pregnant Patients not expected to survive for more than 24 hours
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: High Frequency
Provide standard ventilatory support for burn patients utilizing high frequency percussive ventilation
|
Ventilatory support delivering high frequency percussive ventilation using the Volumetric Diffusive Respirator
Other Names:
|
|
ACTIVE_COMPARATOR: Conventional
Standard ventilator support for non burned patients utilizing lung protective low tidal volume ventilation
|
Respiratory support with a conventional mode of ventilation using a conventional ventilator (Draeger Evita XL)
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Ventilator-free Days During the First 28 Days
Time Frame: 28 days
|
The primary end point was ventilator-free days in the first 28 days, defined as the number of days after randomization from day 0 to day 28 alive without ventilator assistance for at least 48 consecutive hrs.
|
28 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Days Free From Nonpulmonary Organ Failure
Time Frame: 28
|
days free from nonpulmonary organ failure as adapted from the ARDSnet study in the first 28 days.
|
28
|
|
Death
Time Frame: during hospitalization
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In-hospital death.
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during hospitalization
|
|
Ventilator Associated Pneumonia
Time Frame: 28 days
|
Those who develop both clinical and microscopic evidence of pulmonary infection while on the ventilator.
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28 days
|
|
Need for Rescue Ventilator
Time Frame: 28 days
|
Subjects who did not meet predetermined oxygenation and ventilation goals on the study mode despite ventilator- specific optimization were switched to a rescue mode of ventilation.
|
28 days
|
|
Barotrauma
Time Frame: 28 days
|
Defined as a new pneumothorax, pneumomediastinum, subcutaneous emphysema, interstitial emphysema, or pneumatocele >2 cm in diameter not associated with a vascular procedure, lung biopsy, or thoracentesis.
|
28 days
|
|
Ventilator Associated Tracheobronchitis (VATB)
Time Frame: checked daily
|
Defined as carinal or mainstem airway friability and sloughing with associated bleeding.
Only diagnosed after the patient had spent at least 7 days on the assigned ventilator mode and had not been diagnosed with inhalation injury on admission
|
checked daily
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Kevin K Chung, MD, United States Army Insitute of Surgical Research
Publications and helpful links
General Publications
- Acute Respiratory Distress Syndrome Network; Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000 May 4;342(18):1301-8. doi: 10.1056/NEJM200005043421801.
- Salim A, Martin M. High-frequency percussive ventilation. Crit Care Med. 2005 Mar;33(3 Suppl):S241-5. doi: 10.1097/01.ccm.0000155921.32083.ce.
- Chung KK, Wolf SE, Renz EM, Allan PF, Aden JK, Merrill GA, Shelhamer MC, King BT, White CE, Bell DG, Schwacha MG, Wanek SM, Wade CE, Holcomb JB, Blackbourne LH, Cancio LC. High-frequency percussive ventilation and low tidal volume ventilation in burns: a randomized controlled trial. Crit Care Med. 2010 Oct;38(10):1970-7. doi: 10.1097/CCM.0b013e3181eb9d0b.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- H-06-005
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