BJA/RCoA -CAI joint funded Collaborative Research Grant

Sheffield Teaching Hospitals NHS Foundation Trust

Title
Early PReserved SPONtaneous breathing activity in mechanically ventilated patients with acute respiratory distress syndrome - The PReSPON Randomized Controlled Feasibility Trial

Amount
£83,026

Scientific Abstract
Preserved early spontaneous breathing in ARDS, may reduce ventilator associated lung injury, increase aeration in dependent parts of the lung, improve cardiac filling and decrease the need for sedation. However, controlled mechanical ventilation with reduced tidal volumes (CMV) has also been shown to be effective in the ventilation of these patients. Therefore, we aim to compare CMV against Airway Pressure Release Ventilation (APRV) a mode that permits spontaneous breathing. Patients with ARDS fulfilling inclusion criteria will be randomized to receive either ventilator strategy for ≥ 48hrs. This will be a feasibility study of 40 patients with moderate to severe ARDS, recruited over one year, plus follow up and analysis in 2 countries (Eire and UK). This will enable us to gain experience and extend into the full study. It will assist the recruitment of centres with experience of the two ventilator techniques and the study protocol; discover difficulties in recruitment, costs and patient numbers and so define full time frame and acceptability to staff, patients and relatives and strengthen cost estimations, as well as assist detailed planning of substudies. Primary end points will be ventilator free days before day 28 and all-cause mortality by day 28.