Last updated on September 2008

Airway Pressure Release Ventilation in Acute Lung Injury

Are you eligible to participate in this study?

You may be eligible for this study if you meet the following criteria:

  • Conditions: Acute Lung Injury | Acute Respiratory Distress Syndrome | Mechanical Ventilation
  • Age: Between 18 - 100 Years
  • Gender: Male or Female
  • Other:
    Acute onset of:
    PaO2 / FiO2 ≤ 300
    Bilateral infiltrates consistent with pulmonary edema on frontal chest radiograph.
    The infiltrates may be patchy, diffuse, homogeneous, or asymmetric
    Requirement for positive pressure ventilation via endotracheal tube, and
    No clinical evidence of left atrial hypertension.
    Receiving conventional MV, or LPV, in the AC mode with PEEP > 5 cm H2O Criteria 1-3
    must occur within a 24-hour period. "Acute onset" is defined as follows: the duration
    of the hypoxemia criterion (#1) and the chest radiograph criterion (#2) must be < 7
    days at the time of randomization.

You may not be eligible for this study if the following are true:

  • FiO2 > 70% or PaO2/FiO2 < 125 or arterial pH < 7.25
    Greater than 6 days since all inclusion criteria are met
    Anticipated to begin weaning from MV within 48 hours
    Neuromuscular disease that prevents the ability to generate spontaneous tidal
    Glasgow Coma Scale (GCS) < 15 within 1 week of intubation
    Acute stroke (vascular occlusion or hemorrhage)
    Current alcoholism or previous daily use of opioids or benzodiazepines before
    Acute meningitis or encephalitis
    Pregnancy (negative pregnancy test required for women of child-bearing potential) or
    Severe chronic respiratory disease
    Previous barotraumas during the current hospitalization
    Clinical evidence of bronchoconstriction on bedside examination (i.e., wheezing).
    Patient, surrogate, or physician not committed to full support
    Severe chronic liver disease (Child-Pugh Score B or C)
    INR > 2.0
    Platelet level < 50,000
    Mean arterial pressure < 65, or patient receiving intravenous vasopressors (any dose
    of epinephrine, norepinephrine, phenylephrine, or dopamine > 5 mcg/kg/min)
    Age < 16 years old
    Morbid obesity (greater than 1kg/cm body weight).
    No consent/inability to obtain consent
    Unwillingness of the clinical team to use conventional low tidal-volume protocol for
    Moribund patient not expected to survive 24 hours.

Recruitment Status: Open

Brief Description Eligibility Contact Research Team

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