Brigham and Women's Hospital
The goal of this clinical trial is to learn if a breathing machine (ventilator) method called "variable ventilation" can help protect the lungs of adult patients with acute respiratory distress syndrome (ARDS) who need help breathing through a ventilator. In variable ventilation, the size of each breath given by the machine changes slightly from breath to breath, instead of staying the same size in every breath. The study has two parts, A (safety and feasibility) and B (efficacy). This entry will cover the part A (safety study). The main questions part A aims to answer are: 1. Is variable ventilation safe to use in adults with ARDS? 2. Is it feasible to deliver this method of ventilation to patients? Researchers will compare variable ventilation to the standard breathing machine method used today to see if variable ventilation is safe and feasible. Participants will be placed on an FDA approved ventilator that can deliver conventional mechanical ventilation and variable ventilation. Participants will: * Have a period of stabilization on conventional ventilation, followed by 24 hours of variable ventilation, followed by 24 hours of conventional ventilation. * Be checked regularly for breathing, oxygen levels, lung function, and plasma biomarkers.
Inclusion Criteria: 1. Patients ≥21 years old admitted to the Surgical, Trauma, Burn, Coronary or Medical ICUs with ARDS according to the Berlin criteria \[50\] and requiring mechanical ventilation will be eligible for inclusion. 2. Not more than 96 hours of mechanical ventilation before randomization 3. Anticipated need for at least 48 more hours of controlled mechanical ventilation 4. Intubated and mechanically ventilated for ARDS according to the Berlin criteria * Hypoxemia of acute onset, within the past 7 days * Mild or moderate hypoxemia, PaO2/FiO2 ratio 100 - 300 mm Hg * Pres…
Strategy of mechanical ventilation based on varying tidal volume breath to breath to provide therapeutic benefits in patients with ARDS.
Strategy of mechanical ventilation based on delivery of a constant size low tidal volume.