Switching from controlled to assisted ventilation in patients with respiratory failure
Unraveling the (patho)physiological Mechanisms and Potential Clinical Benefits of an Early Switch from Controlled to Assisted Ventilation
This study is testing if switching patients with severe breathing problems from controlled to assisted ventilation earlier can help their recovery and reduce complications.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 20 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Erasmus Medical Center Academic / other |
| Locations | 1 site (Rotterdam) |
| Trial ID | NCT06438198 on ClinicalTrials.gov |
What this trial studies
This physiological intervention focuses on the early transition from controlled mechanical ventilation to assisted ventilation in adult patients suffering from acute hypoxemic respiratory failure. The switch will occur when the patient's PaO2/FiO2 ratio exceeds 200 mmHg, with continuous monitoring of lung stress using electrical impedance tomography and pressure measurements. The study aims to understand the physiological mechanisms involved and assess the clinical benefits of this early switch, which may help mitigate the adverse effects of prolonged controlled ventilation.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18 and older with acute hypoxemic respiratory failure requiring mechanical ventilation.
Not a fit: Patients expected to require mechanical ventilation for less than 48 hours or those with chronic obstructive pulmonary disease exacerbations may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could improve lung function and patient outcomes in those requiring mechanical ventilation.
How similar studies have performed: While the specific approach of this study is novel, related studies have indicated potential benefits of early transitions in ventilation strategies.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * 18 years old * Written informed consent from a legal representative * Mechanical ventilation via an endotracheal tube * Acute hypoxemic respiratory failure with PaO2/FiO2 ratio \< 200 mmHg * Under continuous sedation with or without paralysis Exclusion Criteria: * Expected mechanical ventilation duration of \<48 hours * Pure chronic obstructive pulmonary disease exacerbation * Pre-existent respiratory muscle disease * Contraindication to EIT monitoring (as per clinical protocol, e.g. pacemaker, burns or thoracic wounds limiting electrode placement) * Contra-indications to oesophageal manometry (as per clinical protocol, e.g., recent oesophageal surgery, oesophageal varices, severe bleeding disorders) * Known pregnancy * Anticipating withdrawal of life support and/or shift to palliation as the goal of care
Where this trial is running
Rotterdam
- Erasmus MC — Rotterdam, Netherlands (Recruiting)
Study contacts
- Principal investigator: Annemijn Jonkman, PhD — Erasmus Medical Center
- Study coordinator: Annemijn Jonkman, PhD
- Email: a.jonkman@erasmusmc.nl
- Phone: +3110-7035142
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.