- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02070666
Preventive Strategies in Acute Respiratory Distress Syndrome (ARDS) (EPALI)
Preventive Strategies in Acute Respiratory Distress Syndrome
The investigators hypothesis is that patients at risk of ARDS, detected by LIPS (Lung Injury Prediction Score), under mechanical ventilation could benefit from a protective ventilatory strategy (used in ARDS treatment) in order to avoid or decrease the ARDS development. This would lead to a decrease in incidence, mortality and health care costs associated to this syndrome.
This study will help to confirm the current evidence about low tidal volumes, evaluating adverse events of this strategy.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Barcelona
-
Sabadell, Barcelona, Spain, 08208
- Hospital de Sabadell, CSUPT
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients within 12 hours after start of invasive mechanical ventilation (MV) and admitted to participating ICU (it is recommended an inclusion as soon as possible during the first 3 hours).
- LIPS > 4 points.
- Absence of mild, moderate and severe ARDS criteria (Berlin definition).
- Older than 18 year-old.
- Signed informed consent
Exclusion Criteria:
- Bilateral pulmonary infiltrates in chest X-ray at admission.
- Mechanical ventilation > 12 hours.
- Previous pneumonectomy or lobectomy.
- Severe cranial trauma (Glasgow Coma Scale<9) or cranial hypertension.
- Severe chronic pulmonary disease (GOLD IV).
- Admission from other hospital under MV.
- Limitation of therapeutic effort.
- Pregnancy.
- Acute pulmonary embolism.
- Participation in other interventional trials.
- Previous randomized in the proposed trial.
- Absence of informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Protective ventilation arm
|
Ventilation mode: volume control, pressure control, dual modes (It is allowed to change to a spontaneous mode; a minimum of 5 cmH2O level of support should be used; in case the resulting tidal volume exceeds 6 mL/kg PBW this is accepted. This is not a reason to use more sedation and/or muscle relaxants, or to switch the ventilator to a controlled mode of ventilation).
Volumetric capnography will be used.
Dead space (Vd/Vt) measurements will be taken at baseline and daily after initiation of mechanical ventilation.
Nursing and respiratory care activities (including changes to ventilator settings) will be suspended for at least 5 minutes prior to all Vd/Vt measurements.
|
Active Comparator: Control group
Traditional-sized tidal volumes (from 8 to 10 mL/kg PBW)
|
Volumetric capnography will be used.
Dead space (Vd/Vt) measurements will be taken at baseline and daily after initiation of mechanical ventilation.
Nursing and respiratory care activities (including changes to ventilator settings) will be suspended for at least 5 minutes prior to all Vd/Vt measurements.
Ventilation mode: volume control, pressure control, dual modes (It is allowed to change to a spontaneous mode, with the level of support adjusted to reach tidal volumes minimum of 8 mL/kg predicted body weight PBW; if it is not possible, the data collection should be continue and an intention-to-treat analysis will be done).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
ARDS development
Time Frame: 7 days
|
To determine the effect of a protective mechanical ventilation strategy using lower tidal volumes as compared to mechanical ventilation using traditionally-sized tidal volumes on development of ARDS.
|
7 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mortality
Time Frame: 90 days
|
In-hospital mortality, 28-day mortality and 90-day mortality
|
90 days
|
Ventilator-free days
Time Frame: 28 days after admission
|
From 1 to 28 days over 28 days in a month
|
28 days after admission
|
Dead space
Time Frame: 7 days
|
Volumetric capnography
|
7 days
|
Length of stay
Time Frame: participants will be followed for the duration of ICU (Intensive Care Unit) and hospital stay, an expected average of 4 weeks
|
ICU stay and hospital stay
|
participants will be followed for the duration of ICU (Intensive Care Unit) and hospital stay, an expected average of 4 weeks
|
Pneumonia
Time Frame: 7 days
|
Incidence of pneumonia
|
7 days
|
Atelectasis
Time Frame: 7 days
|
Incidence of atelectasis
|
7 days
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- EPALI
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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