Acute respiratory distress syndrome
Conditions
Interventions
Control group:Early use of assist/control (A/C) mode
Experimental group:Early use of assist/control (A/C) mode
Sponsors
West China Hospital, Sichuan University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Timing: withing 1 week of known clinical insult or new or worsening respiratory symptoms; 2. Chest imaging: bilateral opacities-not fully explained by effusions, labar/lung collapse, or nodules; 3. Origin of edema: 1) respiratory failure not fully explained by cardiac failure or fluid overload; 2) need objective assessment (eg, echocardiagraphy) to exclude hydrostatic edema if no risk factor present; 4.Oxygenation: oxygen index (PaO2/FiO2) >100mmHg but =200mmHg with PEEP or CPAP=5cmH2O.
Exclusion criteria
Exclusion criteria: 1. Age <18 years old; 2. Pregnancy; 3. Severe arrhythmia or acute myocardial ischemia; 4. Pneumothorax or mediastinal emphysema; 5. Intracranial hypertension; 6. Neuromuscular diseases; 7. Severe abdominal distension; 8. Chronic obstructive pulmonary disease (COPD); 9. Severe organ dysfunction with Marshall scale =3 or SOFA scale =3, including shock, severe liver and kidney dysfunction, upper gastrointestinal bleeding, DIC, et al.; 10. Advanced cancer, expected survival time <6 months; 11. After cardiopulmonary resuscitation; 12. Hematological disease: such as aplastic anemia, sickle cell anemia, leukemia, et al.; 13. Immunosuppressed patients (the presence of immunosuppression was considered if meeting one of the following conditions): 1) Recent neutrophil count <500/mm3 for more than 10 days; 2) allogeneic stem cell transplanting recipient, entity organ transplantation, hematologic malignancies; 3) long-term use of corticosteroids: the average daily use of equivalent dose of prednisone not less than 0.3mg/kg, for at least 3 weeks; 4) in the past 90 days received T lymphoid cytostatic therapy, such as cyclosporine, tumor necrosis factor blockers, specific monoclonal antibodies (such as alemtuzumab), and other nucleoside analogues; 5) severe immunodeficiency: such as chronic granulomatous disease and severe combined immunodeficiency diseases; 14. Participating in other clinical trials 30 days before inclusion; 15. Refusing endotracheal intubation and invasive mechanical ventilation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Oxygenation;Length of mechanical ventilation;Delirium rate; | — |
Secondary
| Measure | Time frame |
|---|---|
| Sedative drug dosage;ICU mortality rate;Hospital mortality rate;Length of ICU stay;Cost of ICU stay;SIMV+PSV failure rate;Patient-ventilator asynchrony rate; | — |
Countries
China
Contacts
Public ContactLiang Zongan
West China Hospital, Sichuan University
Outcome results
None listed