About: Model-based PEEP titration versus standard practice in mechanical ventilation: a randomised controlled trial

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About: Model-based PEEP titration versus standard practice in mechanical ventilation: a randomised controlled trial Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Model-based PEEP titration versus standard practice in mechanical ventilation: a randomised controlled trial
Creator	Kim, Benyo, Balazs Chase, J Desaive, Thomas Docherty, Paul Howe, Sarah Knopp, Jennifer Moeller, Knut Morton, Sophie Pretty, Christopher Shaw, Geoffrey Szlavecz, Akos Kyeong, Tae Shiong Chiew, Yeong
source	Medline; PMC
abstract	BACKGROUND: Positive end-expiratory pressure (PEEP) at minimum respiratory elastance during mechanical ventilation (MV) in patients with acute respiratory distress syndrome (ARDS) may improve patient care and outcome. The Clinical utilisation of respiratory elastance (CURE) trial is a two-arm, randomised controlled trial (RCT) investigating the performance of PEEP selected at an objective, model-based minimal respiratory system elastance in patients with ARDS. METHODS AND DESIGN: The CURE RCT compares two groups of patients requiring invasive MV with a partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio ≤ 200; one criterion of the Berlin consensus definition of moderate (≤ 200) or severe (≤ 100) ARDS. All patients are ventilated using pressure controlled (bi-level) ventilation with tidal volume = 6–8 ml/kg. Patients randomised to the control group will have PEEP selected per standard practice (SPV). Patients randomised to the intervention will have PEEP selected based on a minimal elastance using a model-based computerised method. The CURE RCT is a single-centre trial in the intensive care unit (ICU) of Christchurch hospital, New Zealand, with a target sample size of 320 patients over a maximum of 3 years. The primary outcome is the area under the curve (AUC) ratio of arterial blood oxygenation to the fraction of inspired oxygen over time. Secondary outcomes include length of time of MV, ventilator-free days (VFD) up to 28 days, ICU and hospital length of stay, AUC of oxygen saturation (SpO(2))/FiO(2) during MV, number of desaturation events (SpO(2) < 88%), changes in respiratory mechanics and chest x-ray index scores, rescue therapies (prone positioning, nitric oxide use, extracorporeal membrane oxygenation) and hospital and 90-day mortality. DISCUSSION: The CURE RCT is the first trial comparing significant clinical outcomes in patients with ARDS in whom PEEP is selected at minimum elastance using an objective model-based method able to quantify and consider both inter-patient and intra-patient variability. CURE aims to demonstrate the hypothesized benefit of patient-specific PEEP and attest to the significance of real-time monitoring and decision-support for MV in the critical care environment. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry, ACTRN12614001069640. Registered on 22 September 2014. (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366838&isReview=true) The CURE RCT clinical protocol and data usage has been granted by the New Zealand South Regional Ethics Committee (Reference number: 14/STH/132).
has issue date	2020-02-01(xsd:dateTime)
bibo:doi	10.1186/s13063-019-4035-7
bibo:pmid	32007099
has license	cc-by
sha1sum (hex)	b295c19e06eda21d7458bd9eb394a8492b5209c1
schema:url	https://doi.org/10.1186/s13063-019-4035-7
resource representing a document's title	Model-based PEEP titration versus standard practice in mechanical ventilation: a randomised controlled trial
has PubMed Central identifier	PMC6995650
has PubMed identifier	32007099
schema:publication	Trials
resource representing a document's body	covid:b295c19e06eda21d7458bd9eb394a8492b5209c1#body_text
is schema:about of	named entity 'PEEP' named entity 'oxygen saturation' named entity 'performance' named entity 'objective' named entity 'bi-level' named entity 'length' named entity 'pressure' named entity 'selected' named entity 'partial pressure' named entity 'elastance' named entity 'environment' named entity 'FiO2' named entity 'INSPIRED OXYGEN' named entity 'QUANTIFY' named entity 'PATIENTS' named entity 'VENTILATION' named entity '200' named entity 'PRACTICE' named entity 'OBJECTIVE' named entity 'objective' named entity 'fraction' named entity 'randomised' named entity 'PEEP' named entity 'days' named entity 'scores' named entity 'primary' named entity 'maximum' named entity 'respiratory system' named entity 'time' named entity 'The CURE' named entity 'inspired' named entity 'RCT' named entity 'Christchurch hospital' named entity 'AUC' named entity 'elastance' named entity 'inspired' named entity 'nitric oxide' named entity 'sample size' named entity 'patient care' named entity 'elastance' named entity 'partial pressure of arterial oxygen' named entity 'clinical outcomes' named entity 'mechanical ventilation' named entity 'PEEP' named entity 'ICU' named entity 'ventilator' named entity 'PEEP' named entity 'RCT' named entity 'fraction of inspired oxygen' named entity 'elastance' named entity 'randomised controlled trial' named entity 'membrane oxygenation' named entity 'Glasgow Coma Score' named entity 'ABG' named entity 'weaning' named entity 'contraindicated' named entity 'life-threatening' named entity 'intrapulmonary shunting' named entity 'tachycardia' named entity 'MAP' named entity 'inflammatory mediators' named entity 'PEEP' named entity 'chest x-ray' named entity 'patient outcomes' named entity 'lung function' named entity 'RCT' named entity 'PEEP' named entity 'muscle strength'

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