Since strategies were applied in intensive care medicine, including low tidal volume ventilation, fluid resuscitation, use of antibiotics, restrictive transfusion strategy and bundle of ventilator therapy, the incidence of Acute Respiratory Distress Syndrome (ARDS) has been decreased recent years. However, the mortality of severe ARDS is still higher to 45%. Few medications did were indicated to be effective in working on development of ARDS. Different with other disease, ARDS were difficult to prevent in its later stage like a domino effect. The medication interventions are all used after ARDS was developed, including ulinastatin. The investigators hypothesized that the key point in failure of medication therapy is the delay timing of medication intervention. If given the preventive strategy, such as ulinastatin, the incidence or the severity of ARDS might be decreased. Therefore this is a randomized controlled trial to test the hypothesis of the preventive effect of ulinastatin in ARDS. This is a multi-center, randomized, double blinded, placebo controlled study.
Since strategies were applied in intensive care medicine, including low tidal volume ventilation, fluid resuscitation, use of antibiotics, restrictive transfusion strategy and bundle of ventilator therapy, the incidence of Acute Respiratory Distress Syndrome (ARDS) has been decreased recent years. However, the mortality of severe ARDS is still higher to 45%. Few medications did were indicated to be effective in working on development of ARDS. Different with other disease, ARDS were difficult to prevent in its later stage like a domino effect. The medication interventions are all used after ARDS was developed, including ulinastatin. The investigators hypothesized that the key point in failure of medication therapy is the delay timing of medication intervention. If given the preventive strategy, such as ulinastatin, the incidence or the severity of ARDS might be decreased. Ulinastatin is a urinary trypsin inhibitor (UTI) that inhibits various inflammatory proteases has been widely used in China, Japan, and Korea for the treatment of patients with inflammatory disorders, postoperative organs protection, shock, and pancreatitis. Therefore this is a randomized controlled trial to test the hypothesis of the preventive effect of ulinastatin in ARDS. This is a multi-center, randomized, double blinded, placebo controlled study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
840
200,000 IU ulinastatin will be dissolved in 100 mL of 0.9% normal saline by continuous intravenous infusion for 1h, 3 times per day for 5 days.
Usual care in ICU.
Peking University Third Hospital
Beijing, Beijing Municipality, China
Beijing Anzhen Hospital ,Capital Medical University
Beijing, Beijing Municipality, China
Beijing Shijitan Hospital Affiliated to Capital Medical University
Beijing, Beijing Municipality, China
Chinese Pla General Hospital
Beijing, Beijing Municipality, China
Peking University Shenzhen Hospital
Shenzhen, Guangdong, China
The first affiliated hospital of Guangxi Medical University
Nanning, Guangxi, China
CANGZHOU People's Hospital
Cangzhou, Hebei, China
The First Affiliated Hospital of Zhengzhou University
Zhengzhou, Henan, China
The second hospital of dalian medical university
Dalian, Liaoning, China
Central Hospital of Zi Bo
Zibo, Shandong, China
The incidence of ARDS
Time frame: 3 years
The numbers of ARDS patients who meet the criteria for mild, moderate, and severe using the Berlin Definition, separately.
The severity of ARDS will be assessed by the Berlin Definition in mild, moderate and severe ARDs according to oxygenation.
Time frame: 3 years
The number of patients who need mechanical ventilation
Time frame: 3 years
Lengths of mechanical ventilation
Time frame: 3 years
Lengths of ICU
Time frame: 3 years
Lengths of stay
Time frame: 3 years
The incidence of other organ disorders
Time frame: 3 years
Mortality of 28 days
Time frame: 0-28 days
Mortality of 60 days
Time frame: 0-60 days
Total cost in admission
Time frame: 3 years
Adverse events related to drugs.
Time frame: 3 years
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