Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: A Multi-centre Randomised Controlled Trial of an Open Lung Strategy Including Permissive Hypercapnia, Alveolar Recruitment and Low Airway Pressure in Patients With Acute Respiratory Distress Syndrome.
Brief Summary: Some people develop the condition called acute respiratory distress syndrome (ARDS). This is a condition where the lungs have become injured from one of a number of various causes, and do not work as they normally do to provide oxygen and remove carbon dioxide from the body. This can lead to a reduced amount of oxygen in the patient's bloodstream. Patients with ARDS are admitted to the intensive care unit (ICU) and need help with their breathing by being connected to a ventilator (breathing machine). ARDS can lead to injury in other organs of the body causing other problems but also death.

Over the past few years, reducing the size of each breath delivered by the ventilator in conjunction with the use of an occasional sustained deep breath called a "recruitment manoeuvre" have been used to try to prevent further damage to the lungs in people with ARDS. This ventilator strategy (termed the PHARLAP strategy) has been shown in a small research study to have some beneficial effects without causing any obvious harm, when compared to a current best practice ventilator strategy. The main beneficial effects of the PHARLAP strategy were to increase the amount of oxygen in the blood and to reduce markers of inflammation (the body reacting to a disease process) in the body. This study was too small to make a strong conclusion, so this study will be much larger and will assess whether patients who have developed ARDS are better off when we use the PHARLAP strategy. Three hundred and forty patients will be enrolled into this study in multiple ICUs across Australia and New Zealand.

The study hypothesis is that the PHARLAP strategy group will have a higher number of ventilator free days at day 28 than the control group.


Options:
A: Arm Label: PHARLAP ventilation group; Type: EXPERIMENTAL; Interventions: Other: PHARLAP mechanical ventilation strategy | Arm Label: Control group ventilation; Type: ACTIVE_COMPARATOR; Interventions: Other: Control group mechanical ventilation strategy | Intervention Type: OTHER; Name: PHARLAP mechanical ventilation strategy; Assigned to Arm(s): PHARLAP ventilation group | Intervention Type: OTHER; Name: Control group mechanical ventilation strategy; Assigned to Arm(s): Control group ventilation
B: Arm Label: Focal ARDS; Type: EXPERIMENTAL; Interventions: Procedure: Mechanical ventilation | Arm Label: non focal ARDS; Type: OTHER; Interventions: Procedure: Mechanical ventilation | Intervention Type: PROCEDURE; Name: Mechanical ventilation; Assigned to Arm(s): Focal ARDS, non focal ARDS
C: Arm Label: One Group; Type: N/A; Interventions: N/A
D: Arm Label: EPVent; Type: EXPERIMENTAL; Interventions: Procedure: Placement of an esophageal balloon measurements, Other: Transpulmonary pressure-directed ventilation (EPVent) | Arm Label: Control; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Placement of an esophageal balloon measurements, Other: Low tidal volume ventilation | Intervention Type: PROCEDURE; Name: Placement of an esophageal balloon measurements; Assigned to Arm(s): Control, EPVent | Intervention Type: OTHER; Name: Low tidal volume ventilation; Assigned to Arm(s): Control | Intervention Type: OTHER; Name: Transpulmonary pressure-directed ventilation (EPVent); Assigned to Arm(s): EPVent

Answer: A