Comparison of Volume Assist Control, Dual Mode and Airway Pressure Release Ventilation. (COMIX-R)

January 8, 2024 updated by: University Hospital, Angers

Comparison of Volume Assist Control, Dual Mode and Airway Pressure Release Ventilation: A Physiological Study

The aim of the COMIX-R study is to assess the short term physiological effects of 3 ventilation strategies for adult patients with ARDS admitted to intensive care unit

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
20

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • France
      • Angers, France, 49100
        • University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 18 years or older
  • Invasive mechanical ventilation on tracheal probe
  • Acute respiratory distress syndrome, as defined by Berlin conference consensus, during hospitalization in intensive care,
  • Recovery phase of acute respiratory distress syndrome: spontaneous ventilation representing from 20 to 30% of ventilation in APRV mode.
  • No severe acidosis (pH> 7.30)
  • Patient affiliated to or beneficiary of a health care plan
  • Express consent of the patient or his/her SDM

Exclusion Criteria:

  • Pneumothorax
  • Contraindication to the insertion of a nasogastric tube with an esophageal balloon
  • Contraindication to the use of Electrical impedance tomography (pacemaker)
  • Pregnancy, lactating or parturient woman

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Dual Mode first
Four consecutive steps (45 min per step) in the following order: APRV (A), Dual Mode (B) , APRV (A) and VAC (C). (ABAC)
Other: ventilation strategy
Patients are ventilated in randomised order with three different ventilation strategies: volume assist control (constant flow), Dual Mode or Airway Pressure Released Ventilation
Experimental: VAC fist
Four consecutive steps (45 min per step) in the following order: APRV (A), VAC (C) , APRV (A) and Dual Mode (B). (ACAB)
Other: ventilation strategy
Patients are ventilated in randomised order with three different ventilation strategies: volume assist control (constant flow), Dual Mode or Airway Pressure Released Ventilation

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
change of PaO2 (mmHg)
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
Arterial partial pressure of dioxygen Of note: As it is a physiological study, all the primary and secondary outcomes will be analyzed with the same importance.
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
-Respiratory rate variability
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
variability of rate (per minute)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-expiratory and inspiratory transpulmonary pressure
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
calculated with the esophageal pressure (cm H20)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-ventilation distribution in the lungs
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
Electrical impedance tomography (EIT) assess distribution of tidal volume and of end-expiratory lung volume (EELV) (delta Z, IU)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-other arterial parameters of hematosis
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
pH, PaO2, PaCo2 (mmHg)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Work of breathing (WOB)
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
calculated with esophageal pressure (Kg/m)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Pressure time product (PTP)
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Pressure time product (PTP) calculated with esophageal pressure (cmH2O.s.min-1)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-P0.1
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
pressure measured during the first 100 ms after an occlusion (cm H20)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-PEEPi
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
intrinsic positive end-expiratory pressure (cm H20)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
MAP
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
mean arterial pressure
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
HR
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
heart rate (beats per minute)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Respiratory comfort
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
visual analogic scale
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Patient-ventilator asynchronies
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
numbers of asynchronies analyzed on screen
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
-Tidal volume variability
Time Frame: 15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes
variability of Tidal volume (mL)
15 minutes, 1 hour, 1hour and 45 minutes, 2 hour and 30 minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University Hospital, Angers

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Francois BELONCLE, CCU-AH, Angers teatching hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 30, 2020

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 26, 2022

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 26, 2022

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 12, 2019

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 11, 2019

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 12, 2019

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
January 9, 2024

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 8, 2024

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 49RC19_0195

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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