Mechanical Ventilation Strategy for Coronavirus Disease 2019 (COVID-19)
Last updated on July 2021Recruitment
- Recruitment Status
- Recruiting
- Estimated Enrollment
- Same as current
Summary
- Conditions
- Mechanical Ventilation
- Respiratory Distress Syndrome
- Severe Acute Respiratory Syndrome Due to Coronavirus (SARS-CoV2)
- Type
- Interventional
- Phase
- Not Applicable
- Design
- Allocation: RandomizedIntervention Model: Parallel AssignmentIntervention Model Description: Prospective, randomized, single-center, open-label, superiority, controlled trialMasking: None (Open Label)Primary Purpose: Treatment
Participation Requirements
- Age
- Between 18 years and 125 years
- Gender
- Both males and females
Description
We will follow the ventilator strategy of the ARDS Network low PEEP-FiO2 table in the control arm. This strategy consists of at least 12 hours of controlled mechanical ventilation following prespecified PEEP and FiO2 combinations chosen dynamically targeting oxygenation. Tidal volume is set at 4-6 m...
We will follow the ventilator strategy of the ARDS Network low PEEP-FiO2 table in the control arm. This strategy consists of at least 12 hours of controlled mechanical ventilation following prespecified PEEP and FiO2 combinations chosen dynamically targeting oxygenation. Tidal volume is set at 4-6 mL/Kg of predicted body weight (PBW) and plateau pressure is kept below 30 centimeters of water (cmH2O). Respiratory rate can be as high as 35 breaths per minute titrated to a potential of hydrogen (pH) 7.30-7.45. As oxygenation improves, patients are transitioned to assisted ventilation and then to pressure support ventilation until they are ready to be liberated from the ventilator. During this phase, no attempt is made to control plateau pressures or tidal volumes. In the intervention arm, we will focus on minimizing tidal lung strain by keeping driving pressure below 16 cmH2O throughout the mechanical ventilation period. The controlled phase will last at least 48 hours. PEEP will be selected according to a PEEP titration maneuver with EIT at the start of the intervention. This PEEP level will be kept until extubation. Respiratory rate can be as high as 50 breaths per minute targeting a pH of 7.15-7.45.
Tracking Information
- NCT #
- NCT04497454
- Collaborators
- InCor Heart Institute
- Investigators
- Not Provided