[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"acute-hypoxic-respiratory-failure\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:acute-hypoxic-respiratory-failure":26},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,4,0,[8,98,124,151],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":14,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":22,"briefSummary":24,"conditions":25,"keywords":28,"overallStatus":85,"whyStopped":4,"lastUpdateSubmitDate":86,"lastUpdatePostDateStruct":87,"startDateStruct":90,"completionDateStruct":92,"leadSponsor":94,"locationsCount":97},"100635867","win-ratio-analysis-to-determine-a-strategy-of-non--invasive-support-for-respiratory-failure-in-the-emergency-department-100635867",false,"NCT07558265","WIN Ratio Analysis to Determine a Strategy of Non- Invasive SUpport for Respiratory Failure in the EmeRgency Department","WINDSURFER","Inclusion Criteria:\n\n* Age ≥18 years\n* Presenting to the Emergency Department (ED) with Acute Hypoxemic Respiratory failure (AHRF), defined as:\n\n  * \\[(respiratory rate ≥25 breaths\u002Fmin) AND (requiring ≥6 L\u002Fmin of oxygen required to maintain SpO2 ≥90%), OR SpO2:FiO2 ratio\\\u003C250\\] OR\n  * Arrival at ED on prehospital Non-Invasive Respiratory Support (NIRS).\n* Clinical need for NIRS\n* Randomization ≤2 hours after identification of need for NIRS\n* Randomization ≤6 hours of ED arrival\n\nExclusion Criteria:\n\n* Urgent need for intubation\n* Cardiac arrest\n* Respiratory arrest\n* Patient not located in the ED\n* Craniofacial anatomic features that prohibit either Non-Invasive Positive Pressure Ventilation (NIPPV) or High Flow Nasal Oxygen (HFNO) interface\n* Tracheostomy or laryngectomy stoma\n* Hemodynamic instability requiring \\>0.2mcg\u002Fkg\u002Fmin of norepinepherine (or equivalent) to maintain mean arterial pressure \\>65mmHg\n* Pre-existing \"do not resuscitate\" or \"do not intubate\" order\n* Home use of non-invasive positive-pressure ventilation for respiratory support of a medical condition other than sleep apnea\n* Transferred from another Emergency Department\n* History of advanced chronic obstructive pulmonary disease\n* History of advanced heart failure\n* Presence of opt-out identification\n* Prisoner\n* Known or apparent pregnant\n* Previous enrollment in WINDSURFER\n* A patient-specific contraindication makes one assigned study intervention unsafe","ALL","18 Years",{"count":19,"type":20},500,"ESTIMATED","INTERVENTIONAL",[23],"NA","The purpose of this clinical trial is to determine the best initial non-invasive respiratory support (NIRS) strategy for adults who present to the emergency department with acute hypoxemic respiratory failure, a condition in which blood oxygen levels are dangerously low and require urgent treatment. This study compares two commonly used non-invasive respiratory support strategies to evaluate their effectiveness and safety, based on important patient outcomes during hospitalization, including survival, the need for invasive mechanical ventilation, and the duration of respiratory support. Participants will be randomly assigned (with an equal chance) to receive one of the following treatments:\n\n* Non-Invasive Positive Pressure Ventilation (NIPPV): Oxygen delivered under pressure through a face mask.\n* High-Flow Nasal Oxygen (HFNO): Oxygen delivered at high-flow through a specially designed nasal cannula placed in the nostrils.\n\nResearchers will compare the two treatment strategies using a hierarchical assessment of major pulmonary outcomes, including:\n\n* Hospital survival\n* Days on mechanical ventilation\n* Duration of non-invasive respiratory support\n\nAs part of the study, researchers will collect:\n\n* Blood and urine samples\n* Physiologic measurements (such as chest movement measured through sensors placed on the skin)\n* Information from participants' medical records",[26,27],"Acute Hypoxic Respiratory Failure","Acute Respiratory Distress Syndrome (ARDS)",[29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,14,81,82,83,84],"Acute Hypoxemic Respiratory Failure","Acute Decompensated Heart Failure","Acute Respiratory Distress Syndrome","BiPAP","BPAP","COPD","Chronic Obstructive Pulmonary Disease","Continuous Positive Airway Pressure","HFNO","High-Flow Nasal Oxygen","EPAP","Expiratory Positive Airway Pressure","FiO2","Inspired Oxygen Fraction","IMV","Invasive Mechanical Ventilation","IPAP","Inspiratory Positive Airway Pressure","MAPE","Major Adverse Pulmonary Events","MV","Mechanical Ventilation","NIRS","Non-Invasive Respiratory Support","NIPPV","Non-Invasive Positive Pressure Ventilation","PaCO2","Partial pressure of carbon dioxide in arterial blood","PaO2","Partial pressure of oxygen in arterial blood","P:F","Ratio of PaO2 to FiO2","RR","Respiratory Rate","P-SILI","Patient Self-Inflicted Lung Injury","RRT","Renal Replacement Therapy","RSFD","Respiratory Support Free Days","S:F","Ratio of SpO2 to FiO2","SpO2","Transcutaneous measurement of peripheral arterial saturation","UADE","Unanticipated Adverse Device Effects","VAS","Visual Analog Scale","VDays","Ventilator Days","VFD","Ventilator-Free Days","WIN ratio analysis to determine a strategy of non-invasive support for respiratory failure in the emergency department trial","WR","WIN Ratio","Bilevel Positive Airway Pressure","NOT_YET_RECRUITING","2026-05-05",{"date":88,"type":89},"2026-05-07","ACTUAL",{"date":91,"type":20},"2026-07",{"date":93,"type":20},"2031-08",{"name":95,"class":96},"Ohio State University","OTHER",2,{"id":99,"slug":100,"hasResults":11,"nctId":101,"briefTitle":102,"officialTitle":102,"acronym":4,"eligibilityCriteria":103,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":104,"targetDuration":4,"studyType":21,"phases":106,"briefSummary":107,"conditions":108,"keywords":4,"overallStatus":113,"whyStopped":4,"lastUpdateSubmitDate":114,"lastUpdatePostDateStruct":115,"startDateStruct":117,"completionDateStruct":119,"leadSponsor":121,"locationsCount":123},"100554594","optimizing-care-in-critically-ill-at-uchealth-by-liberalizing-the-target-o2-in-mechanically-ventilated-icu-patients-100554594","NCT06501118","Optimizing Care in Critically Ill at UCHealth by Liberalizing the Target O2 in Mechanically-ventilated ICU Patients","Inclusion Criteria:\n\n* Admission to ICU and requiring invasive mechanical ventilation\n\nExclusion Criteria:\n\n* Transferred patients from outside the UCHealth system\\*:\n* Patients with pre-existing disease that requires chronic use of positive pressure ventilation delivered through a tracheostomy\\*:\n* Pregnant women:\n* Prisoners\n* Patients receiving mechanical ventilation for less than twelve hours",{"count":105,"type":20},3600,[23],"A multimodal educational intervention to target an oxygen saturation target range (SpO2 90-96%) will reduce ventilator length of stay and reduce occult hypoxemia by increased awareness and adherence to a designated oxygen saturation target range.",[109,29,26,110,111,112],"Respiratory Failure","Hypoxemia","Hypoxia","Hypoxic Respiratory Failure","RECRUITING","2026-05-04",{"date":116,"type":89},"2026-05-08",{"date":118,"type":89},"2024-09-01",{"date":120,"type":20},"2026-07-31",{"name":122,"class":96},"University of Colorado, Denver",1,{"id":125,"slug":126,"hasResults":11,"nctId":127,"briefTitle":128,"officialTitle":129,"acronym":130,"eligibilityCriteria":131,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":132,"targetDuration":4,"studyType":21,"phases":134,"briefSummary":135,"conditions":136,"keywords":139,"overallStatus":113,"whyStopped":4,"lastUpdateSubmitDate":143,"lastUpdatePostDateStruct":144,"startDateStruct":146,"completionDateStruct":147,"leadSponsor":149,"locationsCount":123},"100556553","inspiratory-effort-targeted-pressure-support-ventilation-it-psv-trial-100556553","NCT06526598","Inspiratory Effort-Targeted Pressure Support Ventilation (IT-PSV) Trial","A Cluster Randomized Trial on Inspiratory Effort-Based Pressure Support Adjustment Strategy in Patients Undergoing Assisted Mechanical Ventilation","IT-PSV","Mechanically ventilated patients, who are admitted to the ICU with acute hypoxic respiratory failure, will be consecutively screened daily at 08:00-10:00 morning rounds.\n\nInclusion criteria:\n\n1. PSV initiated during the last 24 hours;\n2. Mechanical ventilation expected to be required for at least 24-48 h by responsible physicians;\n3. The partial pressure of oxygen in arterial blood (PaO2)\u002Finspired oxygen fraction (FiO2) ≤ 300 mmHg (measuring at clinical FiO2 and positive end-expiratory pressure PEEP);\n4. No sedation or stable sedation with Richmond Agitation Sedation Scale (RASS) of -2 to +1 or Riker's Sedation-Agitation Scale (SAS) of 3 to 4.\n\nExclusion criteria included:\n\n1. Age younger than 18 years old;\n2. Initiation of PSV before ICU admission;\n3. Duration of mechanical ventilation longer than 7 days before enrollment;\n4. History of neuromuscular diseases;\n5. Clinical suspicion of increased intracranial pressure;\n6. Extracorporeal support;\n7. Moribund conditions;\n8. Refusal by the ICU physicians or the patient.",{"count":133,"type":20},619,[23],"The Inspiratory effort-Targeted Pressure Support Ventilation (IT-PSV) is a cluster randomized controlled trial. Its main aim is to determine whether an inspiratory effort-targeted pressure support setting strategy, compared to the traditional tidal volume and respiratory rate target, can improve clinical outcomes in adult participants undergoing pressure support ventilation.\n\nThe investigators propose a physiological-oriented assisted ventilation management that, if found effective, could potentially change the clinical practice for mechanical ventilation.",[137,26,138],"Critical Care","Ventilator-Induced Lung Injury",[140,141,142],"pressure support ventilation","pressure muscle index","inspiratory effort","2026-01-19",{"date":145,"type":89},"2026-01-21",{"date":143,"type":89},{"date":148,"type":20},"2027-02-28",{"name":150,"class":96},"Capital Medical University",{"id":152,"slug":153,"hasResults":11,"nctId":154,"briefTitle":155,"officialTitle":156,"acronym":4,"eligibilityCriteria":157,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":158,"targetDuration":4,"studyType":21,"phases":160,"briefSummary":161,"conditions":162,"keywords":164,"overallStatus":113,"whyStopped":4,"lastUpdateSubmitDate":165,"lastUpdatePostDateStruct":166,"startDateStruct":168,"completionDateStruct":170,"leadSponsor":172,"locationsCount":123},"100575213","a-pilot-trial-of-pressure-muscle-index-targeted-psv-trial-100575213","NCT06769360","A Pilot Trial of Pressure Muscle Index-Targeted PSV Trial","A Pragmatic Pilot Trial Evaluating Inspiratory Pressure Adjustment Based on Pressure Muscle Index in Patients Undergoing Pressure Support Ventilation","Inclusion Criteria:\n\n1. PSV initiated during the last 24 hours, whether transition from controlled modes or primary initiation;\n2. Mechanical ventilation expected to be required for at least 24-48 hours by responsible physicians;\n3. The partial pressure of oxygen in arterial blood (PaO2)\u002Finspired oxygen fraction (FiO2) ≤ 300 mmHg (measuring at clinical FiO2 and positive end-expiratory pressure \\[PEEP\\]);\n4. No sedation or stable sedation with Richmond Agitation Sedation Scale (RASS) of -2 to +1 or Riker's Sedation-Agitation Scale (SAS) of 3 to 4.\n\nExclusion Criteria:\n\n1. Age younger than 18 years old;\n2. Initiation of PSV before ICU admission;\n3. Duration of mechanical ventilation longer than 7 days before enrollment;\n4. History of neuromuscular diseases;\n5. Clinical suspicion of increased intracranial pressure;\n6. Presentation with pneumothorax and\u002For bronchopleural fistula;\n7. Extracorporeal support;\n8. Moribund conditions;\n9. Refusal by the ICU physicians or the patient.",{"count":159,"type":20},60,[23],"Pressure support ventilation (PSV) is one of the most frequently used ventilator modes in the intensive care unit (ICU). The successful implementation of PSV depends on matching the patient's inspiratory effort with the ventilator support. In clinical practice, the pressure support level is usually set and adjusted according to tidal volume (VT) and respiratory rate (RR). However, these parameters may not fully represent the patient's effort. Previous studies have shown that pressure muscle index (PMI), which is measured as the difference between the peak and plateau airway pressure during an end-inspiratory airway occlusion, could reliably determine the low and high inspiratory effort during PSV.\n\nHowever, the comparative effectiveness of these two pressure support level setting strategies remains uncertain. Our aim is to explore clinical and implementation factors relevant to a future definitive randomized controlled trial to evaluate PMI - and VT\u002FRR - pressure support level setting strategies. The Inspiratory effort-targeted pressure support ventilation pragmatic pilot trial will test clinician adherence and to explore clinical outcomes.\n\nTwo centers are included in a pragmatic sequential cluster crossover pilot trial. We enrolled all eligible adults with acute respiratory failure requiring mechanical ventilation admitted to ICU. The pressure support level setting strategy was assigned according to the epoch. The first trial epoch will be assigned to VTRR - pressure support level setting strategy for 4 weeks. The washout week between the two epochs will be 4 weeks. Then sequentially, it will be crossed over to PMI - pressure support level setting strategy for 4 weeks.\n\n* In the VT\u002FRR-targeted group, the pressure support is adjusted to obtain a VT between 6 and 8 ml\u002Fkg PBW and RR between 20 and 35 breaths\u002Fmin until day 28 or death or performance of spontaneous breathing trial (SBT).\n* In the PMI-targeted group, the pressure support is adjusted according to PMI between 0 and 2 cmH2O until day 28 or death or performance of SBT.\n\nWe will also survey clinicians to understand potential facilitators and barriers to conducting a definitive randomized trial.",[137,26,163],"Ventilator Lung",[140,141,142],"2025-02-05",{"date":167,"type":89},"2025-02-07",{"date":169,"type":89},"2025-01-20",{"date":171,"type":20},"2025-04",{"name":150,"class":96}]