COMPARE-VENT Pilot Study Evaluating Pressure-Controlled Versus Volume-Controlled Ventilation in Critically Ill Cardiac Patients on Mechanical Breathing Support

What this Trial Is About

This research evaluates ventilatory modes for patients admitted to the cardiac intensive care unit CICU who require invasive mechanical ventilation due to cardiac disease complicated by respiratory failure. The study addresses the challenge that positive pressure ventilation and sedation can negatively affect heart function and blood flow in these critically ill patients. Since current evidence on optimal ventilation methods in this setting is limited, this pilot trial aims to assess the feasibility of comparing pressure-controlled and volume-controlled ventilation in this population. Participants will receive one of two ventilatory modes during invasive mechanical ventilation in the CICU pressure-controlled ventilation, which delivers breaths with preset airway pressure above positive end-expiratory pressure, or volume-controlled ventilation, which delivers breaths with preset inspiratory flow and tidal volume. The trial uses a cluster-randomized crossover design to pragmatically compare these two modes over the course of mechanical ventilation expected to last more than 12 hours. During the study, researchers will monitor adherence to the assigned ventilation mode and the timing of its initiation within 48 hours of enrollment. They will also assess clinical outcomes such as in-hospital mortality, ventilator-free days, organ failure-free survival, ICU length of stay, and safety measures including sedation levels and patient-ventilator synchrony up to 28 days. The study aims to gather data on how these ventilation methods affect heart and lung function in critically ill cardiac patients.

COMPARE-VENT Feasibility Pilot Study