Avalanche-like opening of airways during ventilation in ARDS
Official title: Avalanche Phenomenon During Airways Opening in Acute Respiratory Distress Syndrome
Run by Poitiers University Hospital · NCT05224323 · Data updated 2026-11-12
This project will test whether airways in adults with moderate-to-severe ARDS open in an 'avalanche' pattern during mechanical ventilation.
Quick facts
| Study type | Observational |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 50 (estimated) |
| Sponsor | Poitiers University Hospital Academic / other |
| Locations | 1 site (Poitiers) |
| Status | Recruiting |
| Started | March 1, 2022 |
| Main results expected | September 2026 |
| Study ends | October 2026 |
| Registry record updated | December 24, 2025 |
| Trial ID | NCT05224323 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (≥18) with moderate-to-severe ARDS within 72 hours of meeting the Berlin criteria who are sedated/paralyzed and receiving invasive mechanical ventilation without spontaneous breathing are ideal candidates.
✕Probably not a fit
Patients with tracheostomy, pneumothorax, bronchopleural fistula, severe hypoxemia, hemodynamic instability, suspected intracranial hypertension, COPD, pacemakers/defibrillators, or decisions to withhold/withdraw life-sustaining measures are excluded and unlikely to benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This observational protocol enrolls adults with moderate-to-severe ARDS early after diagnosis who are invasively ventilated without spontaneous breathing. Investigators will record airway pressure and flow, esophageal pressure, and ventilation distribution while performing controlled inflation maneuvers. The collected signals will be analyzed to detect whether distal airways open unevenly in a rapid, cascade-like sequence during lung inflation. Results aim to clarify mechanisms of atelectrauma and inform safer ventilator settings.
Why it matters
Potential benefit: If confirmed, the findings could help clinicians set ventilator pressures to reduce repetitive airway collapse and lung injury.
How similar studies have gone: Animal experiments and mathematical models have suggested avalanche-like airway opening, but this phenomenon has not been described in humans before.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥ 18 * Moderate-to-severe acute respiratory distress syndrome within the first 72 hours after meeting the Berlin definition criteria: * Within 1 week of a known clinical insult or new or worsening respiratory symptoms; * Bilateral opacities (not fully explained by effusions, lobar/lung collapse, or nodules); * Respiratory failure not fully explained by cardiac failure or fluid overload; * PaO2/FiO2 ≤ 200 mmHg with positive end-expiratory pressure ≥ 5 cmH2O. * Absence of spontaneous breathing efforts * Consent to participate to the study from the patient and/or its surrogate Exclusion Criteria: * Pneumothorax * Broncho-pleural fistula * Tracheostomy * Hemodynamic instability * Severe hypoxemia * Suspected of proven intracranial hypertension * Chronic obstructive lung disease * Pacemaker or defibrillator * Decision to withhold of withdraw life-sustaining measures * Under protection
Where it's running
-
CHU Poitiers
Poitiers, France Recruiting
Study contacts
- Study coordinator: Rémi Coudroy, MD, PhD
- Email: remi.coudroy@chu-poitiers.fr
- Phone: + 33 5 49 44 40 07
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.