Comparison of Gas Exchange Between Two Invasive Mechanical Ventilation Modes in Children

NCT ID: NCT05843123

Last Updated: 2024-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

59 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-15

Study Completion Date

2024-09-20

Brief Summary

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This study assesses the feasibility of digital data collection for a randomized controlled trial in a quaternary pediatric intensive care unit and the effect of two commonly used mechanical ventilation modes on gas exchange (CO2) in children over 2 days after randomization.

This is a single-center, open-labelled, randomized controlled trial with two parallel 1:1 treatment arms: pressure controlled (PC) vs pressure-regulated volume controlled (PRVC) mechanical ventilation modes.

Use to routine digital data is essential to enable health learning systems and to provide rapid clinical trials readiness, as the pandemic has demonstrated. Despite availability of data to perform digital trials in PICU settings, these are yet scarcely done.

Detailed Description

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Conditions

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Respiratory Failure

Keywords

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Pediatrics Child Infant Mechanical ventilation Pressure control Pressure regulated volume control Randomized controlled trial

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a single center, open labelled, randomized controlled trial with one to one allocation to two invasive mechanical ventilation modes used in clinical care as intervention arms
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Pressure control (PC)

In PC physicians set the inspiratory pressure and time, the respiratory rate and the PEEP while the ventilator measures tidal volume and the actual respiratory rate

Group Type ACTIVE_COMPARATOR

Respiratory support b

Intervention Type OTHER

Invasive mechanical ventilation mode

Pressure regulated volume control (PRVC)

In PRVC physicians set a target tidal volume and the respiratory rate. An algorithm delivers pressure using a decelerating flow pattern to reach the target tidal volume based on the lung compliance measured during previous breaths.

Group Type ACTIVE_COMPARATOR

Respiratory support a

Intervention Type OTHER

Invasive mechanical ventilation mode

Interventions

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Respiratory support a

Invasive mechanical ventilation mode

Intervention Type OTHER

Respiratory support b

Invasive mechanical ventilation mode

Intervention Type OTHER

Other Intervention Names

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"Target Vent" is the brand name of the PRVC ventilation mode in the Bellavista ventilator

Eligibility Criteria

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Inclusion Criteria

* Informed consent provided by the participant or the participant's parents or legal guardians. In case of an emergency situation, a physician who is independent of the research project must be consulted prior to inclusion in order to safeguard the interests of the test subject.
* Admission to PICU at the University Children's Hospital Zurich
* Need for mechanical ventilation for \>60 min during PICU hospitalization. Need for mechanical ventilation will be based on clinical decision of the treating physician.
* Need for an arterial line during PICU hospitalization. Need for an arterial line will be based on clinical decision of the treating physician.
* Age \<18 years
* Weight \>2 Kg

Exclusion Criteria

* Substantial air leaks around the endotracheal tube (\>30%)
* Cyanotic shunt lesions
* Intracranial hypertension (i.e. traumatic brain injury or patients admitted after neurosurgery)
* Pulmonary hypertension under treatment (i.e sildenafil or inhaled nitric oxide)
* Time from start of invasive mechanical ventilation until time of screening is \> 24 hours
* Previous enrolment in the study in the past 30 days
* Inability of the parents or legal guardians to understand the study due to linguistic or cognitive reasons
Minimum Eligible Age

0 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Children's Hospital, Zurich

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rebeca Mozun, MD PhD

Role: PRINCIPAL_INVESTIGATOR

University Children's Hospital, Zurich

Locations

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University Children's Hospital Zurich

Zurich, Canton of Zurich, Switzerland

Site Status

Countries

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Switzerland

References

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Mozun R, Chopard D, Zapf F, Baumann P, Brotschi B, Adam A, Jaeggi V, Bangerter B, Gibbons KS, Burren J, Schlapbach LJ. Comparison of carbon dioxide control during pressure controlled versus pressure-regulated volume controlled ventilation in children (CoCO2): protocol for a pilot digital randomised controlled trial in a quaternary paediatric intensive care unit. BMJ Open. 2025 Jan 11;15(1):e087043. doi: 10.1136/bmjopen-2024-087043.

Reference Type DERIVED
PMID: 39800404 (View on PubMed)

Other Identifiers

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CoCO2

Identifier Type: -

Identifier Source: org_study_id