Treatment of mechancally ventlated adults wiith Acute Respratory Distress Syndrome (ARDS) Respiratory
Conditions
Interventions
The intervention will be Nebulized Furosemide, in a dose of 40 mg furosemide in four ml of 0.9% saline, administered every six hours via the ventilator circuit over 30 minutes. The nebulization circu
Sponsors
King Saud Medical City
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adults (=18 years). 2. ICU admission. 3. Mechanical ventilation for <7 days. 4. ARDS diagnosed within 24 hours per Berlin Definition, which includes: 4.1. Chest x-ray showing bilateral opacities, not fully explained by effusions, lobar/lung collapse, or nodules. 4.2. Respiratory failure not fully explained by cardiac failure or fluid overload, and exclusion of hydrostatic edema (by echocardiography). 4.3. Oxygenation and ventilator settings matching one of the three categories of ARDS: Mild: 200 mm Hg < PaO2/FIO2 = 300 mm Hg with PEEP or CPAP = 5 cm H2O. Moderate: 100 mm Hg < PaO2/FIO2 = 200 mm Hg with PEEP = 5 cm H2O. Severe: PaO2/FIO2 = 100 mm Hg with PEEP = 5 cm H2O.
Exclusion criteria
Exclusion criteria: 1. Pregnant or lactating ladies. 2. Patients who are not expected to survive more than 48 hours, according to the treating team. 3. Mechanical ventilation is expected to continue for less than 48 hours (due to rapid recovery) according to the treating team. 4. Advanced directive of Do Not Resuscitate (DNR). 5. Refusal to participate in the trial by the patient, or official surrogate. 6. Known allergy to furosemide. 7. Previous enrollment in the trial (a patient can only be enrolled once).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 28 day mortality measured using hospital records | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. All-cause hospital mortality is measured using hospital records at discharge 2. ICU length of stay (LOS) is measured using ICU records at discharge 3. Hospital length of stay (LOS) is measured using hospital records at discharge 4. Difference of P/F ratio is measured using arterial blood gas analysis at day one and day seven (not calculated for patients who are censored before seven days) 5. Ventilator-free days (VFD) is measured using ventilator records at 28 days 6. Successful extubation rate is measured using patient records at extubation 7. Hypersensitivity reactions of any magnitude are measured using patient reports and clinical assessments at any time during the study 8. Abnormal lab investigations, specifically electrolytes and renal function tests, are measured using blood tests at baseline and at regular intervals during the study 9. Volume of urine output is measured using urine output records at baseline and at regular intervals during the study | — |
Countries
Saudi Arabia
Contacts
Public ContactWaleed Aletreby
Outcome results
None listed