Adherence to Low Tidal Volume in the Transition to Spontaneous Ventilation in Patients With Acute Respiratory Failure

NCT ID: NCT06042036

Last Updated: 2023-11-18

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

UNKNOWN

Total Enrollment

422 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-06-12

Study Completion Date

2024-10-12

Brief Summary

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The goal of this observational study is to estimate the prevalence of the use of protective ventilation with low tidal volume ventilation in the transition of spontaneous ventilation modes in patients with hypoxemic acute respiratory failure in ICUs in Latin America and its association with patient outcomes.

The main questions it aims to answer are:

* what is the prevalence of the use of low tidal volume ventilation (VT \<8 mL/kg of predicted body weight) in the first 24 hours of spontaneous ventilation modes in patients with hypoxemic acute respiratory failure?
* Is there an association between the rate of adherence to low tidal volume ventilation in spontaneous ventilation modes and the ability to stay off ventilatory support and mortality?

Participants are patients with acute respiratory failure under mechanical ventilation. Investigators will collect data on the ventilatory parameters of participants

* 24 hours before they begin to be ventilated with spontaneous modes of ventilation
* during the first 24 hours of spontaneous ventilation

Investigators will collect several patient-centered clinical outcomes at 28 days after study inclusion, including ventilator-free days and mortality

Detailed Description

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Investigators will conduct a cohort study in Intensive Care Units (ICUs) across Latin America, aiming to include 422 patients with Hypoxemic Acute Respiratory Failure (ARF) and under invasive mechanical ventilation.

The goal of this observational study is to estimate the prevalence of the use of protective ventilation with low tidal volume ventilation in the transition of spontaneous ventilation modes in patients with hypoxemic acute respiratory failure in ICUs in Latin America

The primary objectives are to determine the prevalence of low tidal volume ventilation (VT \< 8 mL/kg of predicted body weight) during the initial 24 hours of spontaneous ventilatory modes in patients diagnosed with hypoxemic ARF and its association with clinically important patient outcomes. Investigators are interested in assessing the rate of adherence to low tidal volume ventilation, defined as maintaining VT \< 8 mL/kg of predicted body weight during the first 24 hours of ventilation in spontaneous mode.They are also interested in measuring the number of days that patients are alive and not receiving ventilatory support and survival at 28 days.

Investigators will also measure the proportion of patients experiencing significant asynchrony during the transition to spontaneous mechanical ventilation, who revert to sedation and controlled mechanical ventilation within the first 24 hours or at any point during mechanical ventilation.

Conditions

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Respiration, Artificial Acute Hypoxemic Respiratory Failure Respiratory Insufficiency

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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acute hypoxemic respiratory failure

Patients with acute hypoxemic respiratory failure transitioning to a spontaneous mode of mechanical ventilation ( PSV, APRV, NAVA, PAV+, CPAP)

Spontaneous mode of mechanical ventilation

Intervention Type OTHER

any mode of mechanical ventilation classified as spontaneous or proportional, mainly pressure support ventilation, but also CPAP, APRV, NAVA, PAV+

Interventions

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Spontaneous mode of mechanical ventilation

any mode of mechanical ventilation classified as spontaneous or proportional, mainly pressure support ventilation, but also CPAP, APRV, NAVA, PAV+

Intervention Type OTHER

Other Intervention Names

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spontaneous ventilation

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 years
* Patients with hypoxemic ARF, defined as a PaO2/FIO2 ratio \<300 mmHg, under controlled invasive mechanical ventilation, with an expected duration of MV of at least 24h.
* Patients transitioning to spontaneous ventilation modes (PSV, PAV Plus, NAVA or APRV)

Exclusion Criteria

* Tracheostomized patients.
* Decision not to maintain or add life support measures on the day of assessment (palliative care).
* Patient in ECMO.
* Air fistula or barotrauma that prevents adequate tidal volume monitoring.
* Severe injuries to the central nervous system that result in abolished or very high respiratory drive, for whom it is not possible to maintain protective tidal volume.
Minimum Eligible Age

18 Years

Maximum Eligible Age

110 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Brazilian Research In Intensive Care Network

NETWORK

Sponsor Role collaborator

Latin American Intensive Care Network (LIVEN)

UNKNOWN

Sponsor Role collaborator

University of Sao Paulo General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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JULIANA C FERREIRA, MD

Role: PRINCIPAL_INVESTIGATOR

University of Sao Paulo

Locations

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Sanatorio Juncal SA

Buenos Aires, , Argentina

Site Status RECRUITING

Hospital Municipal Boliviano Holandés, Universidad Mayor de San Andrés

La Paz, , Bolivia

Site Status NOT_YET_RECRUITING

Hospital das Clínicas -HCFMUSP

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Pontificia Universidad Catolica de Chile

Santiago, , Chile

Site Status RECRUITING

Clinica Universidad de la Sabana

Chía, , Colombia

Site Status RECRUITING

Hospital Eugenio Espejo

Quito, , Ecuador

Site Status RECRUITING

Hospital Civil Fray Antonio Alcalde

Guadalajara, , Mexico

Site Status RECRUITING

Hospital San Roque

Asunción, , Paraguay

Site Status RECRUITING

Hospital Rebagliati

Lima, , Peru

Site Status RECRUITING

Hospital Espanol

Montevideo, , Uruguay

Site Status RECRUITING

Countries

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Argentina Bolivia Brazil Chile Colombia Ecuador Mexico Paraguay Peru Uruguay

Central Contacts

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Fabia D Silva, PhD

Role: CONTACT

34992484248

Juliana C FERREIRA, MD

Role: CONTACT

11983355876

Facility Contacts

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Pablo Gomez

Role: primary

Adrian Avilla

Role: primary

Juliana C Ferreira, MD

Role: primary

+5511983355876

Alejandro Bruhn

Role: primary

Luis Felipe Reyes

Role: primary

Manuel Jibaja

Role: primary

Miguel Ibarra

Role: primary

Gabriel Preda

Role: primary

Rollin Roldan

Role: primary

Nicolas Nin

Role: primary

Other Identifiers

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28482720.0.1001.0068

Identifier Type: -

Identifier Source: org_study_id

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