Personalized Mechanical Ventilation Using Lung Ultrasound to Reduce Mortality in Adults with Moderate or Severe Acute Respiratory Distress Syndrome

What this Trial Is About

Researchers are investigating if personalized mechanical ventilation guided by lung ultrasound LUS can reduce mortality in adult patients with moderate or severe acute respiratory distress syndrome ARDS. ARDS is a serious condition causing low oxygen levels with a high death rate, and identifying lung types as focal or non-focal using LUS may allow tailored ventilation strategies. This multicenter randomized clinical trial aims to compare this personalized approach with standard mechanical ventilation practices. Participants will receive a lung ultrasound exam within 12 hours of ARDS diagnosis to classify lung morphology. Patients will then be randomly assigned either to a group receiving personalized ventilation adjusting settings based on lung type or to a control group receiving standard care ventilation. Personalized ventilation includes specific settings for focal or non-focal ARDS, such as tidal volume, positive end-expiratory pressure PEEP, daily positioning, and repeated ultrasound assessments. The control group will receive ventilation based on established guidelines including standard tidal volume and oxygen settings. Throughout the study, researchers will monitor all-cause mortality at 90 days as the primary outcome. Additional outcomes include mortality at 28 days, ventilator-free days, ICU and hospital length of stay, mortality, and complications like pneumonia or pneumothorax. The study includes safety and feasibility evaluations after the first 80 patients, with data collected from medical records and regular ultrasound exams. Participation involves standard ICU care procedures, and the burden or risks related to the study interventions are considered low.

Personalized Mechanical Ventilation Guided by UltraSound in Patients With Acute Respiratory Distress Syndrome