Animal experimentals have shown that the more physiology-driven airway pressure release ventilation (APRV) methodologies in ARDS may significantly improve alveolar recruitment and gas exchange, increased homogeneity, and attenuate lung injury, without circulatory depression, as compared with conventional low tial volume lung protective ventilation. our previous single centre,random control study showed that clinical benefit for early use of APRV in ARDS. Nonetheless, clinical data on ARDS are still limited, most of them derived from small clinical trials in which variable outdated APRV settings were used, consequently, the findings of these studies were controversial. Additionally, the previous single-centre,random control study showed that clinical benefit for APRV.Therefore,the investigators are ready to design a multiple centres,random control study to further verify the effect of APRV plus protocol in ARDS.
All the patients included will be randomly assigned to receiving APRV plus protocol or low tidal volume ventilation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
840
Physiology-driven APRVplus protocol
Low tidal volume lung protective ventilation
West China Hospital,Sichuan University
Chengdu, Sichuan, China
RECRUITINGmortality
mortality at Day28
Time frame: Day 28
Mechanical ventilation free days
Mechanical ventilation free days at Day28
Time frame: Day 28
oxygenation
oxygenation index:PaO2:fiO2
Time frame: from enrollment to Day7
repiratory system compliance
static repiratory system compliance (ml/cmH2O)
Time frame: from enrollment to Day7
MAP
mean arterial pressure
Time frame: during the mechanical ventilation procedure
sedation depth
RASS scores
Time frame: during the mechanical ventilation procedure
Sedative drug
the total dose of Sedative drug
Time frame: during the mechanical ventilation procedure
successful extubation rate
the rate of successful extubation
Time frame: during the mechanical ventilation procedure
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