Villenave D Ornon

Researchers are evaluating the best way to set mechanical ventilators for patients with acute respiratory distress syndrome ARDS, including those with COVID-19 and non-COVID-19 ARDS. This multicenter randomized controlled trial uses an adaptive design to compare ventilation strategies based on respiratory mechanics, aiming to reduce mortality 60 days after treatment begins. ARDS causes severe lung inflammation that makes ventilation challenging and can lead to ventilator-induced lung injury VILI. The trial includes two groups one receiving standard ventilation care following existing guidelines, and the other receiving individualized ventilation settings based on bedside measurements of lung recruitability and breathing effort. The experimental group undergoes specific maneuvers to assess airway closure and recruitability to set ventilator parameters such as tidal volume and positive end-expiratory pressure PEEP. Both groups receive volume control ventilation, with adjustments made as patients begin spontaneous breathing. Participants will be closely monitored during their ICU stay, with assessments including duration of ventilation, ICU and hospital stay length, organ dysfunction, barotrauma, and mortality at several time points up to 60 days. The main outcome measured is all-cause mortality at 60 days. Data collection, analysis, and patient management follow a shared protocol across both COVID-19 and non-COVID-19 patient groups, with safety and effectiveness monitored throughout the study period.

Researchers are studying whether a structured music program called MUSIC CARE9 can reduce care refusal in older adults with dementia living in nursing homes. Care refusal is when a person with dementia resists or refuses daily care activities like bathing or dressing, which can be stressful for both residents and caregivers. The study compares different ways of using music during care to see if it lowers care refusal, behavioral symptoms, medication use, and caregiver burnout. The study has three groups one receiving usual care where MUSIC CARE9 may be used at caregivers discretion, a second group using 20 minutes of MUSIC CARE9 during daily hygiene care for 4 weeks, and a third group using 40 minutes of MUSIC CARE9 split before and during care for 4 weeks. MUSIC CARE9 delivers personalized instrumental music sequences through a tablet and speakers, following a specific protocol designed to relax and engage residents. Participants will be monitored daily for care refusal levels during hygiene sessions for 4 weeks, with neuropsychiatric symptoms and medication use assessed at baseline, 4 weeks, and 8 weeks. Caregivers will complete burnout questionnaires anonymously at three time points. The study aims to evaluate the impact of this music program on resident care acceptance, behavior, medication needs, and caregiver well-being over the course of the trial.