Acute respiratory distress syndrome (ARDS)
Conditions
Interventions
Group 1:airway pressure release ventilation
Group 2:low tidal volume lung protection ventilation strategy
Sponsors
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Patients who meet the 2012 Berlin ARDS diagnostic criteria and are on invasive mechanical ventilation; 2. PEEP>=5cmH2O, oxygenation index<=250mmHg; 3. The time of endotracheal intubation and mechanical ventilation is less than 48h.
Exclusion criteria
Exclusion criteria: 1. The age is less than 18 years old or more than 80 years old; 2. Obese patients with BMI>=35kg/m^2; 3. Pregnant and lactating patients; 4. The expected time of invasive mechanical ventilation is expected to be less than 48h; 5. Neuromuscular diseases known to require prolonged mechanical ventilation; 6. Severe chronic obstructive pulmonary disease; 7. Intracranial hypertension; 8. Bullae or pneumothorax, subcutaneous emphysema, mediastinal emphysema; 9. ECMO treatment has been performed when entering the ICU; 10. Refractory shock; 11. Severe cardiac dysfunction (New York Heart Association class III or IV, acute coronary syndrome or persistent ventricular tachyarrhythmia), right heart enlargement due to chronic cardiopulmonary disease, after cardiogenic shock or major cardiac surgery; 12. No informed consent was signed.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of days without mechanical ventilation 28 days after randomization; | — |
Secondary
| Measure | Time frame |
|---|---|
| Cytokine content of alveolar lavage fluid;Cytokine content of peripheral blood;Classification of immune cells in alveolar lavage fluid;Classification of immune cells in peripheral blood;Immune cell function of alveolar lavage fluid;Immune cell function of peripheral blood;Oxygenation index;Respiratory mechanics;Lung gas distribution;Lung perfusion;Dead space score;Diaphragm mobility;Diaphragm thickness;Diaphragm thickness change rate;Atelectasis;Cardiac Function;Pulmonary artery pressure;Tricuspid regurgitation;Days of mechanical ventilation;Number of successful extubation;Number of days in ICU;Mortality rate during ICU;The number of days in hospital;Mortality rate during hospitalization;All-cause death 28 days after randomization; | — |
Countries
China
Contacts
Public ContactZou Xiaojing
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Outcome results
None listed