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Sponsored by: |
National Heart, Lung, and Blood Institute (NHLBI) |
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Information provided by: | National Heart, Lung, and Blood Institute (NHLBI) |
ClinicalTrials.gov Identifier: | NCT00399581 |
Acute respiratory distress syndrome (ARDS) is a severe lung condition that causes respiratory failure.
Individuals with ARDS often require the use of an artificial breathing machine, known as a mechanical ventilator.
High frequency oscillatory ventilation (HFOV) is a form of mechanical ventilation that pumps small amounts of air into the lungs at a constant high rate. The purpose of this study is to compare the safety and efficacy of two HFOV methods in individuals with ARDS.
Condition | Intervention | Phase |
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Respiratory Distress Syndrome, Adult |
Procedure: High Frequency Oscillatory Ventilation-Hi Procedure: High Frequency Oscillatory Ventilation-Lo |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study |
Official Title: | Phase II Clinical Trial of Two Approaches to High Frequency Oscillatory Ventilation in Acute Respiratory Distress Syndrome |
Enrollment: | 100 |
Study Start Date: | November 2006 |
Study Completion Date: | June 2009 |
Primary Completion Date: | May 2009 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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HFOV-Lo: Experimental
High Frequency Oscillatory Ventilation using lower mean airway pressures and higher FiO2s.
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Procedure: High Frequency Oscillatory Ventilation-Lo
HFOV will be conducted without routine recruitment maneuvers and with a table of mPaw and FiO2s that include relatively low mPaw's.
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HFOV-Hi: Experimental
High Frequency Oscillatory Ventilation using higher mean airway pressures
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Procedure: High Frequency Oscillatory Ventilation-Hi
HFOV will be conducted with recruitment maneuvers and with a table of mPaw and FiO2s that include higher mPaw's.
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ARDS is a serious condition that involves lung inflammation and fluid accumulation in the air sacs, leading to low blood oxygen levels and respiratory failure. It is often fatal and affects approximately 160,000 individuals each year in the United States. The main form of treatment for ARDS is delivery of oxygen and a continuous level of pressure to the damaged lungs through mechanical ventilation. However, some methods of mechanical ventilation may cause ventilator-associated lung injury (VALI), a condition that can result from overdistension of the lungs during inspiration or from excessive mechanical forces. VALI can delay or prevent healing from respiratory failure.
HFOV is a mechanical ventilation method that pumps small amounts of air into the lungs at a constant high rate.
Because the increments of air are small the likelihood of experiencing overdistension and developing VALI may be reduced. While HFOV is an effective, commonly used ventilation method, there have been no studies that demonstrate the efficacy of HFOV in comparison to the efficacy of conventional mechanical ventilation methods.
This study will compare two different HFOV techniques: the HFOV-Hi method, which uses higher airway pressure, and the HFOV-Lo method, which uses lower airway pressure. The purpose of this study is to compare the safety and efficacy of HFOV-Hi, HFOV-Lo, and standard mechanical ventilation methods in individuals with ARDS.
This study will enroll individuals with ARDS at four Baltimore hospitals. Participants will be randomly assigned to receive either HFOV-Hi or HFOV-Lo. All participants will receive their assigned HFOV method for 7 days, until spontaneous breathing occurs, or until death, whichever occurs first. Blood collected at baseline and Days 1 and 3 will be analyzed for markers of inflammation and lung injury. Participants' clinical status will be monitored until they no longer need ventilation and return home, or for up to 60 days while in the hospital. Individuals being treated for ARDS at the participating hospitals who decline to enroll in the study will be asked for permission to monitor their medical progress. These individuals will not take part in any study procedures, but their clinical information will be used for comparison purposes. Additionally, clinical information on other ARDS patients admitted to the hospital over the previous 2 years will be analyzed.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Acute onset of all of the following criteria within a 24-hour period:
Exclusion Criteria:
United States, Maryland | |
Johns Hopkins Hospital | |
Baltimore, Maryland, United States, 21287 | |
Johns Hopkins Bayview Medical Center | |
Baltimore, Maryland, United States, 21224 | |
University of Maryland Medical Center | |
Baltimore, Maryland, United States | |
United States, Ohio | |
Ohio State University Medical Center | |
Columbus, Ohio, United States | |
United States, Texas | |
Wilford Hall Medical Center | |
San Antonio, Texas, United States |
Principal Investigator: | Roy G. Brower, MD | Johns Hopkins University |
Responsible Party: | Johns Hopkins University School of Medicine ( Roy Brower, MD, Professor of Medicine ) |
Study ID Numbers: | 471, P50 HL073994 |
Study First Received: | November 14, 2006 |
Last Updated: | July 10, 2009 |
ClinicalTrials.gov Identifier: | NCT00399581 History of Changes |
Health Authority: | United States: Federal Government |
Acute Respiratory Distress Syndrome Acute Lung Injury Mechanical Ventilation Lung |
Respiratory Tract Diseases Lung Diseases Respiration Disorders Respiratory Distress Syndrome, Adult Acute Respiratory Distress Syndrome |
Pathologic Processes Disease Respiratory Tract Diseases Lung Diseases |
Syndrome Respiration Disorders Respiratory Distress Syndrome, Adult |