Last updated on September 2005

Comparison of 2 Strategies of Adjustment of Mechanical Ventilation in Patients With Acute Respiratory Distress Syndrome


Brief description of study

The aim of this multicenter randomized controlled trial is to compare the impact on mortality of patients mechanically ventilated for acute lung injury or acute respiratory distress syndrome of two strategies for setting end-expiratory pressure.

Detailed Study Description

Most patients suffering from acute lung injury or acute respiratory distress syndrome require mechanical ventilation. In this setting, positive end-expiratory pressure is used to improve arterial oxygenation. While the beneficial effect on clinical outcome of using low tidal volume is clearly proven, the best way to titrate PEEP is not known. Higher PEEP levels may better improve oxygenation and reduce ventilator-induced lung injury by reducing end-expiratory alveolar collapse but may also cause circulatory depression and aggravate lung injury from end-inspiratory overdistension. This trial compares the impact on outcome of two strategies for setting PEEP. In the "minimal alveolar distension" arm, PEEP is set for a total PEEP (PEEP + intrinsic PEEP) between 5 and 9 cm H20). In the "maximal alveolar recruitment" arm, PEEP is set for a plateau pressure between 28 and 30 cm H20. A tidal volume of 6 ml/kg predicted body weight is used in the two arms. The goals for arterial oxygenation and PaCO2 are the same in the two arms.

Clinical Study Identifier: NCT00188058

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LUC RODRIGUEZ, MD

General Hospital of Aix en Provence
Aix-en-Provence, France
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MICHEL OSSART, MD

University Hospital of Amiens
Amiens, France
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ALAIN MERCAT, MD

University Hospital of Angers
Angers, France
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JEAN-PIERRE SOLLET, MD

Victor Dupouy Hospital
Argenteuil, France
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DIDIER DUBOIS, MD

General Hospital of Arras
Arras, France
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BRUNO MOURVILLIER, MD

Robert Ballanger Hospital
Aulnay-sous-Bois, France
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JEROME BAUDOT, MD

General Hospital of Avignon
Avignon, France
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ANNE-MARIE GUERIN, MD

Hospital of Beauvais
Beauvais, France
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OLIVIER GUISSET, MD

Saint Andr Hospital
Bordeaux, France
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GILLES HILBERT, MD

University Hospital of Bordeaux
Bordeaux, France
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ERWAN L'HER, MD

Cavale Blanche Hospital
Brest, France
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ELIAS KARAM, MD

Hospital of Brive
Brive, France
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LAURENT BROCHARD, MD

Henri Mondor Hospital
Creteil, France
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FRANCOIS DECAILLIOT, MD

Henri Mondor Hospital
Créteil, France
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THIERRY MAYET, MD

Hospital of Dax
Dax, France
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MICHEL PINSARD, MD

Hospital of Dieppe
Dieppe, France
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EVA CLEMENTI, MD

Departemental Hospital
La Roche-sur-Yon, France
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JEAN NOUVEAU, MD

Jacques Monod Hospital
Le Havre, France
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CHRISTIAN RICHARD, MD

Le Kremlin Bicetre Hospital
Le Kremlin-Bicetre, France
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DIDIER THEVENIN, MD

Docteur Schaffner Hospital
Lens, France
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PIERRE-ANDRE RODIE TALBERE, MD

University Hospital of Claude Huriez
Lille, France
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CLAUDE GUERIN, MD

Croix Rousse Hospital
Lyon, France
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THIERRY JACQUES, MD

Bon Secours Hospital
Metz, France
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SAMIR JABER, MD

Saint Eloi Hospital
Montpellier, France
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AURELIE CRAVOISY, MD

Hospital of Nancy
Nancy, France
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CHRISTOPHE GUITTON, MD

University Hospital of Hotel Dieu
Nantes, France
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CLAUDE GERVAIS, MD

University Hospital of Nimes
Nimes, France
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JEAN-MARC MAZOU, MD

Oloron Sainte Marie Hospital
Oloron-Sainte-Marie, France
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THIERRY BOULAIN, MD

Regional Hospital of Orleans
Orleans, France
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FREDERIQUE SCHORTGEN, MD

Bichat Claude Bernard Hospital
Paris, France
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JEAN-LUC DIEHL, MD

European Hospital of Georges Pompidou
Paris, France
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JEAN CHASTRE, MD

Hospital Group of Piti - Salp tri re
Paris, France
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ALEXANDRE DUGUET, MD

Hospital group of Piti -Salp tri re
Paris, France
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ANTOINE RABBAT, MD

University Hospital of H tel Dieu
Paris, France
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JEAN-PIERRE FRAT, MD

University Hospital of Jean Bernard
Poitiers, France
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OLIVIER MIMOZ, MD

University Hospital of La Mil trie
Poitiers, France
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JACK RICHECOEUR, MD

Ren Dubos Hospital
Pontoise, France
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BENOIT VEBER, MD

Charles Nicolle Hospital
Rouen, France
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JEAN-CHRISTOPHE RICHARD, MD

University Hospital of Rouen
Rouen, France
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OLIVIER DELASTRE, MD

Saint Aubin Les Elbeuf Hospital
Saint-Aubin-les-Elbeuf, France
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FABRICE ZENI, MD

University Hospital of Bellevue
Saint-Etienne, France
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PIERRE-YVES LALLEMENT, MD

Hospital of Soissons
Soissons, France
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FRANCIS SCHNEIDER, MD

Hautepierre Hospital
Strasbourg, France
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BENOIT GUERY, MD

Gustave Dron Hospital
Tourcoing, France
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