- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01339533
Airway Pressure Release Ventilation (APRV) Versus AC/VC Conventional Ventilation
Airway Pressure Release Ventilation (APRV) vs. Conventional Volume Control Mechanical Ventilation for Patients With Respiratory Failure Requiring Invasive Mechanical Ventilator Support
Study Overview
Status
Intervention / Treatment
Detailed Description
This prospective un-blinded randomized trial will follow patients with respiratory failure and ALI/ARDS who require invasive mechanical ventilation in select ICUs. Patients will be allocated to respiratory support with either APRV mode or volume control (AC) mode of mechanical ventilation. Qualifying patients will be randomized by permuted block randomization within 24 hours of admission to the ICU. Identical ventilation and oxygenation thresholds will be utilized to guide titration of each ventilator protocol. Patients will remain on the assigned mode of ventilation until they are extubated and discharged from the ICU.
Procedures for treatment evaluation include daily monitoring of the Ventilator protocol in each arm. Clinical coordinator and study respiratory therapist will perform 2 daily checks of the study patients to determine compliance with the protocol and if patient meets weaning criteria. The previously published ARDS Network continuous positive airway pressure (CPAP) weaning protocol will be used for all patients enrolled.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Eliotte Hirshberg, MD
- Phone Number: 801-232-9120
- Email: ellie.hirshberg@imail.org
Study Locations
-
-
Utah
-
Murray, Utah, United States, 84157
- Recruiting
- Intermountain Medical Center
-
Principal Investigator:
- Eliotte Hirshberg, MD
-
Salt Lake City, Utah, United States, 84143
- Recruiting
- LDS Hospital
-
Sub-Investigator:
- Terry Clemmer, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Hypoxemic respiratory failure requiring mechanical ventilation for >24 hours.
Exclusion Criteria:
- Age under 18
- Severe chronic obstructive lung disease
- Patients in whom the only indication for mechanical ventilation is airway protection from poor neurological status.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: APRV ls
APRV low stretch will titrate Plow to maintain release volumes between 4 and 8 cc/kg.
|
Patients who experience problems breathing and require assistance in breathing are placed on a machine that delivers air to the lungs through a tube through the vocal cords.
This study is testing 3 protocols for that machine.
|
Active Comparator: AC/VC Conventional Ventilation
Standard volume control ventilation with the ARDS Net protocol.
|
Patients who experience problems breathing and require assistance in breathing are placed on a machine that delivers air to the lungs through a tube through the vocal cords.
This study is testing 3 protocols for that machine.
|
Experimental: APRV h
APRV Habashi protocol which sets Plow equal to 0.
|
Patients who experience problems breathing and require assistance in breathing are placed on a machine that delivers air to the lungs through a tube through the vocal cords.
This study is testing 3 protocols for that machine.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
P/F Ratio on Day 3 of Mechanical Ventilation
Time Frame: Day 3
|
Our first objective is to measure and compare the partial pressure of oxygen in the artery to the inspired oxygen ratio (P/F ratio) on day 3 of mechanical ventilation.
We will also collect and compare common variables used to evaluate lung injury and severity of respiratory failure in both groups.
These variables and markers include: the Oxygenation index (OI) and standard blood gas parameters (PH, PaCO2 and PaO2).
|
Day 3
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Amount/Duration of Sedative & Vasoactive Medication
Time Frame: Up to ICU discharge
|
Our second objective is to compare the amount and duration of sedative medication and vasoactive medication per patient per/day required in each group.
Duration of vasoactive medications and sedation (# of days) and quantitative amounts per kilogram will be compared.
Measurements will include Mean Arterial Blood Pressure (MAP), Central venous pressure (CVP), and daily fluid balance between patients on AC and APRV.
|
Up to ICU discharge
|
Evaluate Feasibility & Clinical Compliance with 2 APRV Paper Protocols.
Time Frame: Up to ICU discharge
|
Our third objective is to evaluate the feasibility of 2 previously developed APRV paper protocols (APRVa and APRVb) and document the clinician compliance with each paper APRV protocol.
We will also track common events associated with mechanical ventilation.
The incidence of pneumothorax defined as any ventilator-barotrauma resulting in chest tube placement, will be carefully followed.
|
Up to ICU discharge
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Eliotte Hirshberg, MD, IHC Health Services, Inc., Dba: Intermountain Medical Center
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- APRV1015758
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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