Lung Open Ventilation to Decrease Mortality in the Acute Respiratory Distress Syndrome

Conditions

Acute Respiratory Distress Syndrome

Brief summary

A multinational, randomized trial comparing two lung protecting strategies of respiratory life support among critically ill patients with severe lung injury.

Detailed description

To compare an innovative Lung Open Ventilation strategy with a proven low tidal volume strategy, hypothesizing that the Lung Open Ventilation strategy may reduce mortality, other organ dysfunction, and the duration of mechanical ventilation, intensive care, and hospital stay.

Sangeeta Mehta, Fadi Hammal, Yoanna Skrobik, John Muscedere, Claudio M. Martin et al. (10 authors)

Annals of Intensive Care2014-11-0614 citations

10.1186/s13613-014-0033-9

Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial.

Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, Davies AR, Hand LE, Zhou Q, Thabane L, Austin P, Lapinsky S, Baxter A, Russell J, Skrobik Y, Ronco JJ, Stewart TE, Lung Open Ventilation Study Investigators.

2008-02-01889 citations

10.1001/jama.299.6.637

Interventions

PROCEDUREControl Ventilation Strategy

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Invasive mechanical ventilation * Acute respiratory insufficiency (within past 28 days) * Bilateral infiltrates on frontal chest radiograph * Hypoxemia, defined as PaO2/FiO2\<=250

Exclusion criteria

* Primary cause of respiratory failure is cardiac * Anticipated duration of mechanical ventilation \< 48 hours * Inability to wean other experimental ventilation strategies * Severe chronic respiratory disease * Neuromuscular disease that will prolong mechanical ventilation * Conditions where hypercapnia-induced intracranial hypertension should be avoided * Morbid obesity (\> 1Kg per cm body weight) * Pregnancy * Very unlikely to survive and lack of commitment to life support Underlying irreversible condition with 6 month mortality \>= 50% * Greater than 48 hours elapsed since first eligible * Current participation in competing trial * Lack of physician, patient or proxy consent

Design outcomes

Primary

Measure	Time frame
Hospital Mortality	—

Secondary

Measure	Time frame
Mortality attributed to respiratory failure	—
Duration of respiratory failure and duration of mechanical failure	—
Evaluation of respiratory function during mechanical ventilation	—
Incidence of barotraumas	—
Non-respiratory organ dysfunction	—

Countries

Canada

Outcome results

None listed