Ventilator

Researchers are studying lung mechanics during the early phase of mechanical ventilation in intensive care and during general anesthesia in surgical patients. The study aims to better understand lung compliance and transpulmonary driving pressures using a new, non-invasive PEEP-step method. This method could improve how ventilator settings are personalized to reduce lung injury and complications, addressing a gap in data collected during the critical first hours of ventilation. The study observes two groups ICU patients receiving ventilator treatment and patients undergoing general anesthesia for surgery. In both groups, a PEEP-step method involves adjusting positive end-expiratory pressure PEEP up and down in one or two steps while measuring changes in lung volume and pressures. This is done directly after intubation and repeated during ventilation or surgery when clinical events occur, using specialized software that analyzes data from standard ventilator monitoring equipment. Participants will be monitored continuously during ventilator treatment or surgery. Measurements include lung elastance and transpulmonary driving pressure, collected before, during, and after respiratory care. Clinical data such as blood gases and ventilator settings are recorded without any invasive procedures. The study assesses lung function changes over time, ventilator duration, and postoperative complications, aiming to enhance ventilator therapy and patient outcomes. Total participation time varies with clinical course.

Researchers are studying patients with severe pneumonia admitted to the Respiratory Intensive Care Unit RICU to understand the epidemiology and clinical characteristics of pneumonia caused by various factors. This observational cohort study aims to gather detailed clinical data including morbidity, mortality, risk factors, symptoms, and radiographic changes to help improve clinical care for severe pneumonia patients. The study involves patients admitted to the RICU due to pneumonia from any cause. There are no specific treatments or interventions being tested, as this is an observational study collecting data during the patients stay. Researchers will observe respiratory support parameters, treatment options, and symptom developments during the initial days and weeks of hospitalization. Participants will be monitored for outcomes such as mortality and morbidity during their time in the RICU, with measurements taken over one year. Data on symptoms within the first 48 hours, respiratory support during the first 5 days, and treatments over 3 weeks will be collected. The study records clinical information to better understand pneumonia in this critical care setting, with participant involvement lasting as long as their hospital stay and follow-up for outcomes.

Amyotrophic lateral sclerosis ALS is a progressive disease that weakens muscles and often leads to breathing problems, which is the leading cause of death in ALS. This research evaluates the timing and method of starting non-invasive ventilation NIV to assist breathing, as current guidelines vary and are not based on large studies. The study aims to explore early use of NIV in ALS patients before insurance criteria for coverage are met, using a new prediction tool to identify those at high risk of respiratory problems within six months. Participants will be randomly assigned to start early NIV or receive usual care, with the early NIV group receiving ventilation support earlier than current U.S. guidelines suggest. The study will collect data on feasibility, symptoms, carbon dioxide levels, and survival outcomes over about one year. The intervention involves using a ventilation device through a mask to help patients breathe and reduce carbon dioxide in the blood, potentially improving survival. Throughout the study, participants will undergo assessments including quality of life questionnaires, sleepiness scales, breathing function tests, and monitoring of NIV use and hospitalizations. The research team will measure the time to first NIV use, carbon dioxide levels, breathing symptoms, and survival without tracheostomy. Data collected will help plan a larger trial and understand which patients are likely to benefit from early NIV and use it consistently over time.

This clinical trial is a phase 2a, multinational, multicenter, double-blind, randomized, placebo-controlled study aimed at evaluating the safety, tolerability, and pharmacokinetics PK of OMN6 in patients with hospital-acquired bacterial pneumonia HABP or ventilator-associated bacterial pneumonia VABP caused by the Acinetobacter baumannii complex ABC. The purpose is to identify safe and well-tolerated doses of OMN6 and understand its behavior in the body when added to standard therapies. Participants receive either OMN6 or a placebo alongside background antibiotic treatment with meropenem and colistin. OMN6 is given in three dosing cohorts 50 mg, 100 mg, or 150 mg, each administered as three 3-hour intravenous infusions on a single day, while meropenem plus colistin treatment continues for 7 to 14 days. The comparator group receives matching placebo infusions under the same schedule plus the background antibiotics. Throughout the study, participants are closely monitored for safety and the pharmacokinetics of OMN6, including measures such as maximum concentration, time to maximum concentration, area under the curve, and half-life. Safety assessments focus on the 28 days following the single-day infusion. The trial includes randomized assignment and double-blinding to ensure unbiased evaluation. The total study duration extends until primary completion in March 2027.

Researchers are evaluating the efficacy and safety of a single intravenous dose of agenT-797 combined with standard of care SOC compared to placebo plus SOC in adults with severe pneumonia and moderate to severe acute hypoxemic respiratory failure AHRF. This trial includes a run-in phase and a double-blinded phase 2, designed to reduce short-term mortality and improve clinical outcomes in this serious condition. The trial consists of two parts an initial open-label Run-in Phase where participants receive agenT-797 plus SOC to characterize the baseline population, followed by a randomized, double-blinded Phase 2 where participants receive either agenT-797 plus SOC or placebo plus SOC. SOC includes antimicrobial therapy and corticosteroids based on applicable guidelines. Treatments are given as intravenous infusions. Participants will be monitored from Day 1 through Day 28 for outcomes such as mortality, oxygenation support-free days, ventilator-free days, ICU-free days, new infections, antibiotic-free days, and time to hospital discharge. Additional assessments include cytokine profile changes at baseline, Day 3, Day 7, and Day 14. The study continues monitoring mortality up to Day 90. Overall, participants undergo intensive evaluations, including safety and efficacy assessments, during the study period lasting until 2027.

Researchers are evaluating a new multi-component score called the Readiness for EXtubation score REXs to predict when ICU patients on invasive mechanical ventilation are ready to be extubated. The process of liberation from mechanical ventilation involves weaning, readiness assessment, and extubation, with success defined as not needing invasive support within 48 hours. This study focuses on developing and analyzing REXs to help clinicians assess extubation readiness more accurately in critically ill patients. The study involves daily screening of ICU patients undergoing weaning from invasive mechanical ventilation. Data collected include clinical parameters such as arterial blood gases, ventilation settings, sedation and agitation scores, heart rate, hemoglobin levels, nutritional status, and cough strength, among others. Clinicians will anonymously enter data into an electronic case report form to develop and evaluate the REXs score. Patients prepared for extubation will have their readiness assessed using this score. Participants will be monitored during their ICU stay, with data collected on extubation success or failure at 24, 48, and 72 hours after extubation. Researchers will also track length of ICU and hospital stays and mortality outcomes. The study uses routine clinical data, with anonymization to protect patient confidentiality. Statistical methods will analyze associations between clinical factors and extubation outcomes to validate the REXs scores predictive ability. The total study duration extends until the end of 2026.

This research aims to develop a new ultrasonographic method to measure regional pulmonary strain in patients who have lung diseases and are receiving mechanical ventilation in an intensive care unit. Mechanical ventilation, while often necessary, can sometimes cause lung injury due to excessive strain or overdistension, especially in patients with severe lung conditions. The study intends to collect initial data on local pleural strain to assist in planning larger studies and potentially help prevent ventilator-induced lung injury. The study involves using lung ultrasonography to image the pleura at four specific locations on the chest in mechanically ventilated patients. The imaging will be performed using a Terason device with a 12L5 linear ultrasound probe, positioned perpendicularly to the pleura. Three consecutive breathing cycles will be recorded at each site. An experienced ultrasonographer and a technician will analyze the images using an algorithm to calculate various pulmonary strain measurements. Participants will undergo lung ultrasound imaging during their ICU stay, with images taken at four predetermined sites on the chest. Researchers will measure several strain components such as lateral and axial deformation and shear using specialized software. The primary outcome is the average absolute lateral deformation measured on the first day. Other measurements include various deformation ranges and shear values. The studys total duration for each participant is based on data collected during Day 1 of their ICU ventilation period.

Researchers are exploring two strategies for setting pressure support levels in patients receiving pressure support ventilation PSV in intensive care units. The study focuses on adults with acute hypoxic respiratory failure who need mechanical ventilation. It aims to compare the traditional method based on tidal volume VT and respiratory rate RR with a newer method using the pressure muscle index PMI, which may better reflect patient inspiratory effort. This pilot trial will examine clinical outcomes and how well clinicians adhere to these strategies to guide future larger studies. The trial involves two treatment periods at two centers using a sequential cluster crossover design. The first 4-week period uses the VTRR-targeted pressure support settings, followed by a 4-week washout, then a 4-week PMI-targeted period. In the VTRR group, pressure support is adjusted to keep VT between 6 and 8 mlkg predicted body weight and RR between 20 and 35 breaths per minute. In the PMI group, pressure support is adjusted to keep PMI between 0 and 2 cmH2O. Both groups receive standard mechanical ventilation care, including sedation and analgesia management, with adjustments made twice daily during PSV. Participants will be monitored daily until weaning, death, discharge, or 28 days after randomization. Data collected include ventilator settings, respiratory and hemodynamic parameters, sedation and analgesia levels, and clinical outcomes such as duration of mechanical ventilation and mortality. The study also includes clinician surveys about the acceptability and feasibility of the PMI-based strategy. This comprehensive approach will help assess the practicality of PMI-targeted pressure support in critical care settings.

Many newborn babies experience breathing difficulties that require intubation, a procedure where a tube is inserted into the windpipe to help with breathing support. This trial compares two methods used by doctors to perform intubation the traditional direct laryngoscopy DL, where doctors look directly into the babys mouth with a standard laryngoscope, and video laryngoscopy VL, which uses a camera and screen to view the windpipe. The study aims to determine if VL leads to more successful first attempts without causing drops in oxygen levels or heart rate compared to DL. The trial uses a stepped-wedge cluster randomized design across multiple hospitals. Initially, each hospital uses the standard DL method for intubation. At randomly assigned intervals, hospitals switch to using the VL device, the C-MAC video laryngoscope, which includes a monitor and special blades. Doctors receive training and practice with this device before switching. Other intubation practices, such as drug use and supplemental oxygen, remain the same throughout the study. Participants in the trial are newborn infants undergoing intubation. Researchers will collect information about intubation attempts, including success rates, oxygen levels, heart rates, and any complications like oral trauma or need for chest compressions. The main outcome is whether babies are successfully intubated on the first try without physiological instability within five minutes. Additional measures include procedure time, number of attempts, and adverse events. Data will be compared between the periods using DL and VL to assess effectiveness and safety over the course of the study, which lasts until August 2026.

Lung cancer is the leading cause of cancer deaths in the UK, often diagnosed late. Current screening mainly targets high-risk groups, missing about 30% of cases, including many women and never-smokers. There is a need for a simple, non-invasive test to help triage patients with persistent respiratory symptoms who do not meet current screening criteria. The Inflammacheck4 device measures hydrogen peroxide and other breath markers linked to airway inflammation and oxidative stress. Previous studies showed it could distinguish lung cancer from other respiratory diseases well. This study aims to validate and improve the AI model behind Inflammacheck4 for quick and accurate lung cancer triage in NHS settings. This is a multi-center, observational study without intervention or randomization. Participants include healthy volunteers and people with lung cancer, suspected lung cancer negative biopsy, pneumonia, non-malignant airway diseases, or other respiratory conditions. The study collects exhaled breath samples using Inflammacheck4 alongside demographic and clinical data. The AI model will be refined by analyzing these breath biomarkers across the different groups. The study includes both retrospective and prospective data integration. Participants will provide breath samples and allow access to clinical data and imaging results. The primary outcome is to refine the AI-based diagnostic model from enrollment until study completion in December 2026. Participants must be able to understand English and perform the breath test. The study excludes those with active infections other than pneumonia, recent major lung surgery, recent cancer treatments, pregnancy, or recent smoking or certain medication use. The total participation time depends on individual enrollment and data collection timing.