Study to Guide Weaning From Venovenous ECMO in Adults With Acute Respiratory Distress Syndrome Using Respiratory Drive Monitoring

What this Trial Is About

Researchers are evaluating the process of weaning patients with Acute Respiratory Distress Syndrome ARDS from veno-venous extracorporeal membrane oxygenation vvECMO. This study focuses on assessing monitoring tools, specifically the pressure generated during a 100-millisecond expiratory occlusion P0.1 and esophageal pressure variation delta Poeso, to guide decisions regarding vvECMO weaning and decannulation. The study aims to improve understanding of how respiratory drive and effort affect mechanical ventilation duration in ARDS patients. Participants will undergo a final vvECMO weaning test with minimal ECMO support, including low ECMO flow and fresh gas flow, while on partial mechanical ventilation allowing spontaneous breathing. One group will have P0.1 and delta Poeso values monitored and used to guide decannulation decisions, while the other group will have these measurements monitored but blinded to the clinical team and not used in decision-making. This randomized, controlled design compares the impact of integrating these monitoring tools on weaning outcomes. During the study, participants will be closely monitored for respiratory parameters, mechanical ventilation duration, and clinical outcomes such as mortality and intensive care unit stay. Researchers will collect P0.1 and delta Poeso measurements from study inclusion until 48 hours after decannulation. Additional assessments include sedation duration, barotrauma incidence, prone positioning, corticosteroid use, and neuromyopathy. The primary outcome is the duration of mechanical ventilation following ECMO removal, with follow-up extending to 60 days after inclusion.

Free for Weaning ECMO vs Respiratory Driven Study