Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Adaptive Support Ventilation vs. Conventional Ventilation Strategy in the Management of Acute Respiratory Distress Syndrome:A Randomized Controlled Trial
Brief Summary: Prospective randomized controlled trial to be conducted in the Respiratory Intensive Care Unit (RICU) of Post Graduate Institute of Medical Education And Research (PGIMER),Chandigarh. The study is approved by the Institute Ethics committee. In view of lack of previous outcome data in such patients, all patients requiring RICU admission for acute respiratory distress syndrome(ARDS) between January 2010 and June 2011 are being enrolled in this pilot study.

The patients meeting the aforementioned criteria will randomly assigned to ventilation with assist control mode ventilation (ACMV group) as per the ARDSnet strategy or adaptive support ventilation (ASV group). Being the first RCT of its type, patients will be first stabilized on ACMV for 1 hour to determine the adequate minute ventilation. The randomization sequence will be computer generated. The assignments will placed in sealed opaque envelopes and each patient's assignment was made on admission to the RICU by the attending physician. Blinding of treatment is not possible.

All patients will be ventilated only by Galileo Gold ventilators (Hamilton medical systems, Bonaduz, Switzerland). Patients randomized to the ACMV group will be ventilated according to low tidal volume strategy of 6ml/kg with Fio2/PEEP as per ARDSnet table to achieve a saturation between 88-95% with the lowest possible Fio2 to maintain plateau pressures \< 30 cms H2o and PH \> 7.3 with option to reduce tidal volume to 4 ml/kg and increase respiratory rate to 35/ min to achieve the above said goals11.These patients will be weaned as per standard protocol of spontaneous breathing trial of 30 minutes once they are recognized eligible as per statement of the sixth International consensus conference on weaning.


Options:
A: Intervention Type: DEVICE; Name: SmartCare/PS; Assigned to Arm(s): N/A
B: Arm Label: Automated settings; Type: EXPERIMENTAL; Interventions: Device: Hamilton ventilator (G5 modify to S1) Automated settings | Arm Label: protocolized settings; Type: ACTIVE_COMPARATOR; Interventions: Other: Hamilton ventilator (G5) protocolized settings | Intervention Type: DEVICE; Name: Hamilton ventilator (G5 modify to S1) Automated settings; Assigned to Arm(s): Automated settings | Intervention Type: OTHER; Name: Hamilton ventilator (G5) protocolized settings; Assigned to Arm(s): protocolized settings
C: Arm Label: 1; Type: EXPERIMENTAL; Interventions: Device: Smartcare/PS | Arm Label: 2; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: DEVICE; Name: Smartcare/PS; Assigned to Arm(s): 1
D: Arm Label: Adaptive support ventilation in ARDS; Type: ACTIVE_COMPARATOR; Interventions: Procedure: type of mechanical ventilation | Arm Label: conventional ventilation strategy in ARDS; Type: ACTIVE_COMPARATOR; Interventions: Procedure: type of mechanical ventilation | Intervention Type: PROCEDURE; Name: type of mechanical ventilation; Assigned to Arm(s): Adaptive support ventilation in ARDS, conventional ventilation strategy in ARDS

Answer: D