Status:

RECRUITING

Platform of Randomized Adaptive Clinical Trials in Critical Illness

Lead Sponsor:

University Health Network, Toronto

Conditions:

Respiratory Insufficiency

Extracorporeal Membrane Oxygenation Complication

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

PRACTICAL is a randomized multifactorial adaptive platform trial for acute hypoxemic respiratory failure (AHRF). This platform trial will evaluate novel interventions for patients with AHRF across a r...

Detailed Description

EXPAND-ECLS domain: The EXPAND-ECLS pilot trial is a multi-center, randomized, open-label, feasibility trial, embedded as a domain within the PRACTICAL platform trial. The ULTIMATE arm of this domain ...

Eligibility Criteria

Inclusion

  • PRACTICAL Platform
  • Acute hypoxemic respiratory failure meeting all of the following criteria;
  • New or worsening respiratory symptoms developing within 2 weeks prior to the onset of need for oxygen or respiratory support
  • Receiving any of the following types of oxygen or respiratory support for at least 4 hours prior to the time of randomization; supplemental oxygen at 10 L/min or higher, high flow nasal oxygen (at any flow rate), invasive ventilator support, extra-corporeal life support (ECLS), or non-invasive ventilator support
  • Minimum FiO2 ≥ 0.40 (for venturi mask, high flow nasal cannula, or invasive or non-invasive ventilation) or oxygen flow rate ≥10 L/min on face mask for at least 4 hours at the time of evaluation for eligibility unless already on extra-corporeal life support
  • Age ≥ 18 years
  • Hypoxemia not primarily attributable to acute heart failure, fluid overload, or pulmonary embolism (PE)
  • PRACTICAL Platform

Exclusion

  • Extubation is planned or anticipated on the day of screening
  • ICU discharged is planned or anticipated on the day of screening
  • If the patient is moribund and deemed unlikely to survive 24 hours (as determined by the clinical team)
  • If the patient is being transitioned to a fully palliative philosophy of care
  • EXPAND-ECLS Domain Inclusion Criteria:
  • Receiving invasive Endotracheal mechanical ventilation for ≤ 72 hours.5 days
  • Early Moderate-severe hypoxemic respiratory failure with a PaO2/FiO2≤150200 mmHg for at least 6 hours
  • EXPAND-ECLS Domain

Key Trial Info

Start Date :

April 30 2023

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

March 31 2027

Estimated Enrollment :

6250 Patients enrolled

Trial Details

Trial ID

NCT05440851

Start Date

April 30 2023

End Date

March 31 2027

Last Update

November 17 2025

Active Locations (80)

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Page 1 of 20 (80 locations)

1

University of Arizona

Tucson, Arizona, United States, 85724

2

University of California Los Angeles (UCLA)

Los Angeles, California, United States, 90095

3

University of San Diego (UCSD)

San Diego, California, United States, 92121

4

University of Colorado Hospital

Aurora, Colorado, United States, 80045