Merano

Researchers are evaluating simple external anatomical landmarks to predict the correct insertion depth of esophageal probes, which is important for accurate core temperature monitoring in adult ICU patients. The study addresses the limitations of current methods based on fixed insertion depths or patient height, aiming to reduce errors caused by probe misplacement. Transesophageal echocardiography (TEE) will serve as the reference standard for confirming correct probe placement. The study involves patients undergoing clinically indicated TEE, during which probe position will be verified. Multiple anatomical measurements will be recorded to assess the accuracy of landmark-based insertion predictions. The investigation focuses on comparing the landmark-based insertion depth with TEE-confirmed placement using statistical methods including Bland-Altman analysis and intraclass correlation coefficients. Participants will be adult ICU patients who require TEE for clinical reasons. The study will involve measuring and documenting probe insertion depths and external anatomical landmarks. Outcome measurement centers on the agreement between the TEE-confirmed insertion depth and the landmark-based prediction. The study emphasizes accurate monitoring of core temperature and reliable probe placement, with data collected during the TEE procedure.

This research aims to evaluate the effectiveness of Pirfenidone, an oral anti-fibrotic drug, in treating patients with Acute Respiratory Distress Syndrome (ARDS), a serious lung condition causing severe inflammation and lung injury. ARDS leads to significant ICU admissions and high mortality rates, with many patients developing lung fibrosis even after the acute phase. Despite many clinical trials, no specific drug treatment has proven clearly effective for ARDS, making this randomized controlled trial important to explore new options. Participants will be randomly assigned to receive either Pirfenidone or a placebo. Pirfenidone will be given through a nasogastric tube in increasing doses: 801 mg per day from days 1 to 7, 1602 mg per day from days 8 to 14, and 2403 mg per day from day 15 until discharge from the ICU. The placebo group will receive a matching treatment schedule via nasogastric tube. The study is designed as a multicenter phase 3 trial to assess the drug's impact on ARDS. During the study, researchers will monitor participants closely, focusing on the number of days they are free from mechanical ventilation within 28 days. The study will include assessments of lung function and inflammation, with ongoing safety monitoring throughout ICU stay. Participants must meet specific criteria, including confirmed moderate to severe ARDS and an inflammatory phenotype. The study seeks to provide clear evidence on whether Pirfenidone can reduce lung fibrosis and improve outcomes in ARDS patients.