The aim of this study is to assess the effects and safety of the early application of BILEVEL-APRV protocol and conventional ventilation strategy that used low tidal volume and adequate PEEP level in ARDS patients .
Although mechanical ventilation is life-sustaining for patients with ARDS, it can perpetuate lung injury. A number of recent advances have greatly improved in the mechanical ventilation strategies and treatment for acute respiratory distress syndrome (ARDS), however, Mortality remains high, even with the use of low tidal volume and adequate positive end expiratory pressure(PEEP). Numerous experimental showed that the BILEVEL-APRV mode used in animal ARDS model can improve gas exchanges and hemodynamic tolerance of the ventilation while reducing the dosage for sedative drugs. The aim of this single-center, prospective, randomized, controlled, open study is to compare the effects and safety of the early application of BILEVEL-APRV protocol and conventional ventilation strategy that used low tidal volume and adequate PEEP level in ARDS patients .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
200
Puritan Bennett 840 ventilator can provide the VCV,PCV,Bi-level Airway Pressure Ventilation-airway Pressure Release Ventilation(BILEVER-APRV) mode.
Department of Critical care medicine of West China Hospital
Chengdu, Sichuan, China
RECRUITINGMechanical ventilation free days
Time frame: day 28
all causes mortality
Participants will be followed for the duration of ICU stay
Time frame: day 60
all cause hospital mortality
Participants will be followed for the duration of hospital stay, until day 60 maximum.
Time frame: day 60
Duration of stay in ICU
Time frame: day 60
Duration of hospital stay
Time frame: day 60
peak airway pressure,mean airway pressure,positive end expiratory pressure(cmH2O)
Time frame: day 7
Average dosage of sedative infusion
Time frame: day 7
Richmond Sedation-Agitation Scale
Time frame: day 7
Average dosage of vasoactive drugs each day in use
Time frame: day 7
number of patients requiring cointerventions and Adjunctive Therapies
Time frame: Day 28
number of patients requiring the use of noninvasive ventilation
Time frame: Day 28
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the tracheotomy rate
Time frame: Day 28
Number of patients with a pneumothorax
Time frame: Day 28
the number of days free from organ dysfunction
Time frame: Day 28
tidal volume(ml)
Time frame: Day 7
static lung compliance(ml/cmH2O)
Time frame: Day 7
PaO2,PaCO2(mmHg)
Time frame: Day 7
Blood pressure(mmHg)
Time frame: Day 7
blood lactic acid(mmol/l)
Time frame: Day 7
minute ventilation (L)
Time frame: Day 7