Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Liberal Oxygenation Versus Conservative Oxygenation in Patients With Acute Respiratory Distress Syndrome : Impact on Mortality (LOCO2 Study)
Brief Summary: No clear recommendation exists for the level of oxygenation of intensive care patients. In Acute Respiratory Distress Syndrome (ARDS), pulsed oxymetry (SpO2) have to be kept between 88 and 95 percent and oxygen alveolar pressure between 55 and 80 mmHg (PaO2). These recommendations are common but do not lie on high scientific knowledge and level of proof. In the major studies of these fifteen last years that changed ARDS management, PaO2 was kept around 85 and 90 mmHg despite current recommendations of 55 to 80 mmHg of PaO2.

Many recent review and cohort studies pointed the risk of excessive oxygenation especially following cardiac arrest, stroke or traumatic brain injury. However, these data come in majority from cohort or database study without strong definition of hyperoxia. Data coming from prospective studies are scarce and tend to show better outcome of patients with lower objectives of oxygenation in ICU.

High oxygen (O2) level may be deleterious especially on inflammatory lungs. It could enhance injuries due to mechanical ventilation. O2 could be responsable of " hyperoxia induced lung injury ".

The investigators showed in a precedent study that comparing a restrictive oxygenation versus a liberal oxygenation was feasable and do not expose patients to major adverse events. More, mortality at 60 days has tendency to be lower. The investigators therefore ask if a lower objectives of PaO2 in comparison with the level usually seen in last studies on ARDS could improve ARDS patients outcome.

The aim of this study is to show that a restrictive oxygenation in comparison with a liberal oxygenation strategy in patients with ARDS would lower mortality at 28 days.


Options:
A: Arm Label: 10 L O2/min; Type: EXPERIMENTAL; Interventions: Drug: Oxygen | Arm Label: Room air; Type: SHAM_COMPARATOR; Interventions: Device: Room air | Intervention Type: DRUG; Name: Oxygen; Assigned to Arm(s): 10 L O2/min | Intervention Type: DEVICE; Name: Room air; Assigned to Arm(s): Room air
B: Arm Label: Low normal MAP and low normal PaO2; Type: ACTIVE_COMPARATOR; Interventions: Other: Low normal MAP, Other: Low normal PaO2. | Arm Label: High normal MAP and low normal PaO2; Type: ACTIVE_COMPARATOR; Interventions: Other: High normal MAP, Other: Low normal PaO2. | Arm Label: Low normal MAP and high normal PaO2; Type: ACTIVE_COMPARATOR; Interventions: Other: Low normal MAP, Other: High normal PaO2 | Arm Label: High normal MAP and high normal PaO2; Type: ACTIVE_COMPARATOR; Interventions: Other: High normal MAP, Other: Low normal PaO2. | Intervention Type: OTHER; Name: Low normal MAP; Assigned to Arm(s): Low normal MAP and high normal PaO2, Low normal MAP and low normal PaO2 | Intervention Type: OTHER; Name: High normal MAP; Assigned to Arm(s): High normal MAP and high normal PaO2, High normal MAP and low normal PaO2 | Intervention Type: OTHER; Name: Low normal PaO2.; Assigned to Arm(s): High normal MAP and high normal PaO2, High normal MAP and low normal PaO2, Low normal MAP and low normal PaO2 | Intervention Type: OTHER; Name: High normal PaO2; Assigned to Arm(s): Low normal MAP and high normal PaO2
C: Arm Label: Liberal oxygen; Type: ACTIVE_COMPARATOR; Interventions: Drug: Liberal Oxygen | Arm Label: Titrated oxygen; Type: EXPERIMENTAL; Interventions: Drug: Titrated Oxygen | Intervention Type: DRUG; Name: Titrated Oxygen; Assigned to Arm(s): Titrated oxygen | Intervention Type: DRUG; Name: Liberal Oxygen; Assigned to Arm(s): Liberal oxygen
D: Arm Label: Liberal Oxygenation (LO) group; Type: ACTIVE_COMPARATOR; Interventions: Drug: Modulation of Inspired Fraction of Oxygen (FiO2) | Arm Label: Conservative Oxygenation (CO) group; Type: EXPERIMENTAL; Interventions: Drug: Modulation of Inspired Fraction of Oxygen (FiO2) | Intervention Type: DRUG; Name: Modulation of Inspired Fraction of Oxygen (FiO2); Assigned to Arm(s): Conservative Oxygenation (CO) group, Liberal Oxygenation (LO) group

Answer: D