Safety Study of Inhaled Carbon Monoxide to Treat Acute Respiratory Distress Syndrome (ARDS)

  • STATUS
    Not Recruiting
  • participants needed
    36
  • sponsor
    Brigham and Women's Hospital
Updated on 23 January 2021
sepsis
edema
carbon monoxide
chest radiograph
acute respiratory distress
FIO2
pao2
positive end expiratory pressure
bilateral pulmonary infiltrates
pao2/fio2 ratio
atelectasis
intermittent positive pressure ventilation
effusions
assisted breathing

Summary

The purpose of this study is to assess the safety of inhaled carbon monoxide (iCO) in intubated patients with sepsis-induced ARDS.

Description

The acute respiratory distress syndrome (ARDS) is a syndrome of severe acute lung inflammation and hypoxemic respiratory failure with an incidence of 180,000 cases annually in the U.S.Despite decades of research and recent advances in lung protective ventilator strategies, morbidity and mortality remain unacceptably high. Furthermore, no specific effective pharmacologic therapies currently exist. The lack of specific effective therapies for sepsis-related ARDS indicates a need for new treatments that target novel pathways. Carbon monoxide (CO) represents a novel therapeutic modality in ARDS based on data obtained in experimental models of ARDS and sepsis over the past decade.

CO has been shown to be protective in experimental models of Acute Lung Injury (ALI), including hyperoxia and endotoxin exposure, bleomycin, ischemia/reperfusion, and ventilator-induced lung injury (VILI). At low doses, CO has been shown to confer tissue protective effects in these ALI models. In addition, CO has been shown to decrease inflammation, enhance phagocytosis, and improve mortality in models of sepsis including endotoxemia, hemorrhagic shock, and cecal ligation and puncture (CLP). CO has also been shown to have beneficial therapeutic effects in pre-clinical models of disease including pulmonary hypertension, vascular injury, and transplantation. Furthermore, multiple human studies have demonstrated that experimental administration of several different concentrations of CO is well tolerated and that low dose inhaled CO can be safely administered to subjects in a controlled research environment.

The purpose of this study is to assess the safety of inhaled CO therapy in mechanically ventilated patients with sepsis-induced ARDS.

Details
Condition ADULT RESPIRATORY DISTRESS SYNDROME
Treatment Inhaled Carbon Monoxide at 100ppm, Placebo for Inhaled Carbon Monoxide at 100ppm, Inhaled Carbon Monoxide at 200ppm, Algorthim Specified dose of iCO to achieve COHb of 6-8%, Placebo for Inhaled Carbon Monoxide at 200ppm, Placebo for Cohort 3, Open-label algorithm-specified dose of iCO to achieve COHb of 6-8%, Inhaled Carbon Monoxide at 100ppm (4 participants), Placebo for Inhaled Carbon Monoxide at 100ppm (2 participants), Inhaled Carbon Monoxide at 200ppm (4 participants), Placebo for Inhaled Carbon Monoxide at 200ppm (2 participants), Open-label algorithm-specified dose of iCO to achieve COHb of 6-8% (6 participants)
Clinical Study IdentifierNCT02425579
SponsorBrigham and Women's Hospital
Last Modified on23 January 2021

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