Condition: ARDS (Acute Respiratory Distress Syndrome) · Sponsor: Assistance Publique Hopitaux De Marseille
In its most severe form, Acute Respiratory Distress Syndrome (ARDS) may require the use of veno-venous ECMO (vvECMO). While the criteria for vvECMO indication, ECMO settings, and ventilator management are relatively well-defined after the publication of the EOLIA trial and subsequent national or international guidelines, few studies have assessed the criteria and methods for weaning from vvECMO. Besides, advances in the understanding of the pathophysiology of mechanical ventilation (MV) weaning process have led to the development of specific monitoring tools for this phase. Schematically, respiratory drive can be evaluated via the ventilator by measuring the pressure generated during a 100-millisecond expiratory occlusion (P0.1) and respiratory efforts through the measurement of esophageal pressure variation (delta Poeso). Recent retrospective studies conducted on COVID-19 ARDS patients supported by vvECMO suggest a longer duration of mechanical ventilation for patients whose weaning and decannulation process was "forced," i.e., performed under conditions of significant respiratory drive and effort. High values of P0.1 and delta Poeso were associated with prolonged MV duration. Self-inflicted lung injury (P-SILI) and elevated transpulmonary pressure related to these uncontrolled respiratory efforts likely explain the negative impact on MV duration. Therefore, this randomized study proposes to assess these monitoring tools, which are regularly used in clinical practice, to …
This description comes directly from the study's public registry record.
Sami HRAIECH, M.D., Ph.D · 04 91 96 58 35 · sami.hraiech@ap-hm.fr
Christophe GUERVILLY, M.D. · 04 91 96 58 35 · christophe.guervilly@ap-hm.fr
Always discuss trial participation with your own doctor first.
| Hospices Civiles de Lyon | Lyon, France | Recruiting |
| Assistance - Publique Hôpitaux de Marseille | Marseille, France | Recruiting |
| CHU de Nice | Nice, France | Recruiting |
| Assistance Publique - Hôpitaux de Paris | Paris, France | Recruiting |
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Source record: clinicaltrials.gov/study/NCT06876415