Evaluating the use of PEEP in patients with acute respiratory failure

Application of PEEP in Patients With Acute Respiratory Failure Caused by Lung Injury: Assessment of Clinical Practice

This study is testing if using a breathing technique called PEEP can help improve oxygen levels and lung function in patients with severe breathing problems who are on a ventilator.

Quick facts

• Study type: Observational
• Enrollment: 15 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Dr. Negrin University Hospital (Academic / other)
• Locations: 3 sites (Las Palmas de Gran Canaria, Las Palmas and 2 other locations)
• Trial ID: NCT04912960 on ClinicalTrials.gov

What this trial studies

This observational study aims to assess the effectiveness of positive end-expiratory pressure (PEEP) in improving oxygenation and compliance in intubated patients with acute respiratory failure requiring mechanical ventilation. The study will evaluate whether the current practice of incrementally increasing PEEP levels leads to optimal outcomes, as previous findings from 1975 have not been validated in modern clinical settings. The research will involve monitoring patients who meet specific criteria, including those with acute hypoxemic respiratory failure. The goal is to determine if the historical application of PEEP remains relevant and beneficial in today's medical practice.

Who should consider this trial

Good fit: Ideal candidates for this study are intubated patients over 18 years old who require mechanical ventilation for more than 24 hours due to acute hypoxemic respiratory failure.

Not a fit: Patients with acute respiratory failure from non-pulmonary origins or those with contraindications to high PEEP will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could refine ventilation strategies for patients with acute respiratory failure, potentially improving their oxygenation and overall outcomes.

How similar studies have performed: While the foundational study from 1975 established the use of PEEP, this current assessment is novel as it seeks to validate those findings in the context of modern ventilation practices.

Eligibility criteria

Inclusion Criteria:

* Intubated patients requiring MV for \>24 h
* Age \>18 years
* Acute hypoxemic respiratory failure, defined as a PaO2/FiO2 \<300 with an FiO2 ≥0.3 and PEEP≥5 cmH2O.
* ARF caused by pulmonary insults.

Exclusion Criteria:

* ARF from non-pulmonary origin.
* Contraindications from high PEEP (severe head trauma or severe chest trauma).
* Patients that cannot maintained supine position.
* Uncorrected hypovolemia
* Hemodynamic instability

Where this trial is running

Las Palmas de Gran Canaria, Las Palmas and 2 other locations

• Hospital Universitario Dr. Negrin — Las Palmas de Gran Canaria, Las Palmas, Spain (Recruiting)
• Hospital Clinic — Barcelona, Spain (Not_yet_recruiting)
• Hospital Universitario La Princesa — Madrid, Spain (Not_yet_recruiting)

Study contacts

• Study coordinator: Jesús Villar, MD

Conditions Acute Respiratory Failure With Hypoxia