Comparison Between Limited Driving Pressure Ventilation and Conventional Mechanical Ventilation Strategies in Medical Intensive Care Patients With Acute Respiratory Failure

Study Overview
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Brief Summary
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Background An appropriated mechanical ventilator setting for acute respiratory failure results of ventilator associated lung injury. Limited driving pressure and low tidal volume ventilation strategies show benefits decreasing mortality in acute respiratory distress syndrome, but there are no data in simple acute respiratory failure.

Detailed Description
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Background An appropriated mechanical ventilator setting for acute respiratory failure results of ventilator associated lung injury. Limited driving pressure and low tidal volume ventilation strategies show benefits decreasing mortality in acute respiratory distress syndrome, but there are no data in simple acute respiratory failure. To compare lung injury score (LIS, Murray score) after invasive mechanical ventilation 7 days between groups of limited driving pressure ventilation versus low tidal volume ventilation strategies.

Official Title
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Comparison Between Limited Driving Pressure Ventilation and Conventional Mechanical Ventilation Strategies in Medical Intensive Care Patients With Acute Respiratory Failure

Conditions
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on Invasive Mechanical Ventilation, ARDS, Respiratory Failure

Intervention / Treatment
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* Procedure: Limited driving pressure
* Procedure: Conventional mechanical ventilation strategies


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 year old MICU patient On Invasive mechanical ventilator less than 24 hr. before randomization Exclusion Criteria: Suspected death within 48 hr. after randomization patients with tracheostomy tube Pregnancy Do not attempt resuscitation order Patient with ECMO before randomization

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Limited driving pressure ventilation<br> | Procedure: Limited driving pressure<br>* Keep driving pressure <15 cmH2O<br>|
| Experimental: Conventional mechanical ventilation strategies<br> | Procedure: Conventional mechanical ventilation strategies<br>* Keep tidalvolume </= 8<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung injury score | Lung injury score (LIS, Murray score) | Day 7 after invasive mechanical ventilation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 28 days Mortality | 28 days Mortality | Upto 28 days | 
| New onset of ARDS | New onset of ARDS | Upto 28 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Limited driving pressure, Low tidal volume, Lung injury score