Vanderbilt University Medical Center
The goal of this clinical trial is to learn whether the choice of ventilator mode for patients on breathing machines in the intensive care unit affects their survival and recovery. To do this, researchers will assign the entire participating intensive care unit to one of the three available ventilator modes, alternating which mode is assigned in random sequence every 2 months. The main question it aims to answer is: Does the choice between volume control, pressure control, and adaptive pressure control affect the number of days that patients are alive and free of the breathing machine?
The MODEM trial is a cluster-randomized, cluster-crossover clinical trial comparing the effectiveness of three ventilator modes (volume control vs pressure control vs adaptive pressure control) for mechanical ventilation of critically ill adults at multiple centers. A total of 4,785 critically ill adults receiving invasive mechanical ventilation in intensive care units will be enrolled and included in the primary analysis. Each study unit will be assigned to a ventilator mode and will switch between modes every 2 months in an order determined by randomization. Enrolled patients will be assigne…
Inclusion Criteria: * Patient is receiving mechanical ventilation through an endotracheal tube or tracheostomy * Patient is physically located in a participating adult ICU Exclusion Criteria: * Patient is known to be less than 18 years old * Patient is known to be a prisoner * Patient is known to have been receiving invasive mechanical ventilation at place of residence prior to hospital admission * Patient is receiving extracorporeal membrane oxygenation at the time when inclusion criteria are first met
Volume control mode for invasive mechanical ventilation
Pressure control mode for invasive mechanical ventilation
Adaptive pressure control for invasive mechanical ventilation