UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000042319
Receipt number R000048290
Scientific Title The Impact of Higher Positive End Expiratory Pressure on Patient Ventilator Asynchrony
Date of disclosure of the study information 2020/11/05
Last modified on 2021/07/13 19:47:24

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Basic information

Public title

The Impact of Higher Positive End Expiratory Pressure on Patient Ventilator Asynchrony

Acronym

The Impact of Higher Positive End Expiratory Pressure on Patient Ventilator Asynchrony

Scientific Title

The Impact of Higher Positive End Expiratory Pressure on Patient Ventilator Asynchrony

Scientific Title:Acronym

The Impact of Higher Positive End Expiratory Pressure on Patient Ventilator Asynchrony

Region

Japan


Condition

Condition

Acute Respiratory Distress Syndrome

Classification by specialty

Emergency medicine Intensive care medicine

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

Patient-ventilator asynchrony is known to frequently occur during lung protective ventilation in patients with ARDS. Previous clinical studies showed that patient-ventilator asynchrony was associated with worse outcome in ICU. Therefore, strategies to reduce patient-ventilator asynchrony need to be established promptly. Several asynchronies, e.g., breath stacking are caused by vigorous spontaneous breathing effort. Recently, our group found that higher positive end expiratory pressure (PEEP) reduced the intensity of spontaneous breathing effort of breathing in severe ARDS model (rabbits, pigs) and patients with ARDS. Thus, we conjectured that higher PEEP may reduce the intensity of spontaneous breathing effort and thereby reduce patient-ventilator asynchrony during protective ventilation strategy, compared with lower PEEP in patients with ARDS.

Basic objectives2

Efficacy

Basic objectives -Others


Trial characteristics_1


Trial characteristics_2


Developmental phase



Assessment

Primary outcomes

Asynchrony index of all types of patient ventilator asynchrony at higher and lower PEEP.

Key secondary outcomes

1. Asynchrony index of each types of patient ventilator asynchrony at higher and lower PEEP.
2. The intensity of spontaneous breathing effort at higher and lower PEEP
3. Minute volume at higher and lower PEEP.
4. The efficiency of diaphragmatic contraction at higher and lower PEEP.


Base

Study type

Interventional


Study design

Basic design

Cross-over

Randomization

Randomized

Randomization unit

Individual

Blinding

Single blind -participants are blinded

Control

Dose comparison

Stratification

NO

Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms

2

Purpose of intervention

Treatment

Type of intervention

Other

Interventions/Control_1

Higher positive end expiratory pressure (PEEP)

Interventions/Control_2

Lower positive end expiratory pressure (PEEP)

Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

18 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

1) Patients over/and 18 years old
2) Patients with moderate-to-severe ARDS under mechanical ventilation

Definition of moderate to severe ARDS is as per the Berlin definition (PaO2/FiO2 under/and 200 mmHg with PEEP over/and 5 cmH2O)

Key exclusion criteria

1) Lack of informed consent
2) Continuous neuromuscular blockade at enrollment
3) DNR (do-not-resuscitate)
4) Moribund patient not expected to survive 24 hours
5) Massive hemoptysis
6) Increased intracranial pressure (> 18 mmHg)
7) Existence or high risk of pneumothorax
8) Known pregnancy
9) Actual body weight exceeding 1 kg/cm
10) Patient judged to be inappropriate for the trial by intensivist

Target sample size

10


Research contact person

Name of lead principal investigator

1st name Takeshi
Middle name
Last name Yoshida

Organization

Osaka University Graduate School of Medicine

Division name

Department of Anesthesiology and Intensive Care Medicine

Zip code

565-0871

Address

2-2, Yamadaoka, Suita, Osaka

TEL

06-6879-3133

Email

takeshiyoshida@hp-icu.med.osaka-u.ac.jp


Public contact

Name of contact person

1st name Takeshi
Middle name
Last name Yoshida

Organization

Osaka University Graduate School of Medicine

Division name

Department of Anesthesiology and Intensive Care Medicine

Zip code

565-0871

Address

2-2, Yamadaoka, Suita, Osaka

TEL

06-6879-3133

Homepage URL


Email

takeshiyoshida@hp-icu.med.osaka-u.ac.jp


Sponsor or person

Institute

Osaka University Hospital

Institute

Department

Personal name



Funding Source

Organization

Japan Science and Technology Agency

Organization

Division

Category of Funding Organization

Japanese Governmental office

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Ethical Review Board, Osaka University Hospital, Osaka University Hospital

Address

2-2, Yamadaoka, Suita city, Osaka

Tel

06-6210-8296

Email

rinri@hp-crc.med.osaka-u.ac.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2020 Year 11 Month 05 Day


Related information

URL releasing protocol


Publication of results

Unpublished


Result

URL related to results and publications


Number of participants that the trial has enrolled


Results


Results date posted


Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Open public recruiting

Date of protocol fixation

2020 Year 09 Month 12 Day

Date of IRB

2020 Year 11 Month 02 Day

Anticipated trial start date

2020 Year 11 Month 05 Day

Last follow-up date

2022 Year 03 Month 31 Day

Date of closure to data entry


Date trial data considered complete


Date analysis concluded



Other

Other related information



Management information

Registered date

2020 Year 11 Month 02 Day

Last modified on

2021 Year 07 Month 13 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000048290


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name