[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"ventilator-associated-pneumonia--vap\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:ventilator-associated-pneumonia--vap":28},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,3,0,[8,49,78],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":17,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":20,"targetDuration":23,"studyType":24,"phases":4,"briefSummary":25,"conditions":26,"keywords":30,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":37,"lastUpdatePostDateStruct":38,"startDateStruct":41,"completionDateStruct":43,"leadSponsor":45,"locationsCount":48},"100635328","innate-immune-immunoparalysis-and-ventilator-associated-pneumonia-in-critically-ill-elderly-patients-100635328",false,"NCT07551258","Innate Immune Immunoparalysis and Ventilator-Associated Pneumonia in Critically Ill Elderly Patients","Intensity and Duration of Innate Immune System Immunoparalysis in the Pathophysiology of Ventilator-Associated Pneumonia in Mechanically Ventilated Elderly Patients","IMP-VM","Inclusion Criteria:\n\n* ≥18 years\n* Mechanical ventilation expected \\>48h\n* Intubation between 24h pre- and 48h post- ICU admission\n* Informed consent\n\nExclusion Criteria:\n\n* Known severe immunosuppression, including primary immunodeficiency disorders, advanced HIV infection (AIDS), active hematological malignancy under treatment, recent chemotherapy or immunosuppressive therapy\n* High dose steroids at immunosuppressive doses\n* Active autoimmune disease\n* Pregnancy\n* End-of-life situation",true,"ALL","18 Years",{"count":21,"type":22},170,"ESTIMATED","90 Days","OBSERVATIONAL","This prospective observational cohort study aims to evaluate the role of innate immune immunoparalysis in the development of ventilator-associated pneumonia (VAP) in critically ill mechanically ventilated patients. Immunoparalysis will be assessed through monocyte HLA-DR expression and ex vivo lipopolysaccharide (LPS)-stimulated TNF-α production.\n\nThe study will include three cohorts: elderly patients (≥65 years), younger adults (\\\u003C65 years), and healthy controls. The primary objective is to determine whether the presence, duration, intensity, and trend of immunoparalysis are associated with the incidence of VAP and other ICU-acquired infections. Secondary objectives include characterization of immunoparalysis dynamics, comparison of measurement methods, and evaluation of clinical outcomes.",[27,28,29],"Intubated ICU Patients","Ventilator Associated Pneumonia ( VAP)","Immunoparalysis",[31,32,33,34,35],"invasive mechanical ventilation","LPS stimulation","HLA-DR","innate immunity","ICU-acquired infections","RECRUITING","2026-05-17",{"date":39,"type":40},"2026-05-19","ACTUAL",{"date":42,"type":22},"2026-05-01",{"date":44,"type":22},"2028-07-31",{"name":46,"class":47},"Hospital Universitari de Bellvitge","OTHER",1,{"id":50,"slug":51,"hasResults":11,"nctId":52,"briefTitle":53,"officialTitle":54,"acronym":55,"eligibilityCriteria":56,"healthyVolunteers":11,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":57,"targetDuration":4,"studyType":59,"phases":60,"briefSummary":62,"conditions":63,"keywords":64,"overallStatus":68,"whyStopped":4,"lastUpdateSubmitDate":69,"lastUpdatePostDateStruct":70,"startDateStruct":72,"completionDateStruct":74,"leadSponsor":76,"locationsCount":48},"100623964","phase-4-combined-use-of-a-respiratory-multiplex-pcr-and-algorithm-based-therapy-to-improve-early-optimization-of-antibiotic-therapy-in-critically-ill-patients-with-ventilator-associated-pneumonia-100623964","NCT07403474","Combined Use of a Respiratory Multiplex PCR and Algorithm-based Therapy to Improve Early Optimization of Antibiotic Therapy in Critically Ill Patients With Ventilator-associated Pneumonia","Combined Use of a Respiratory Multiplex PCR and Algorithm-based Therapy to Improve Early Optimization of Antibiotic Therapy in Critically Ill Patients With Ventilator-associated Pneumonia : a Bicentric, Parallel-group, Randomized Controlled Trial.","SMART-VAP","Inclusion Criteria:\n\n* Adults (≥18 years) with VAP (mechanical ventilation and hospitalization ≥ 48 hours) and deep respiratory sample by mini BAL \\\u003C 12 hours. The diagnosis of pneumonia includes two clinical criteria among fever (≥38.3°C), purulent sputum or aspiration, hyperleukocytosis (\\>12,000 WBC\u002Fmm³) or leukopenia (\\\u003C4,000 WBC\u002Fmm³), hypoxemia, auscultatory signs in the affected area, and a newly-appeared parenchymal infiltrate\n* Patient receiving initial probabilistic antibiotic therapy for VAP suspicion\n* Informed consent or emergency procedure\n* Patient affiliated with or beneficiary of a health insurance plan.\n\nNon inclusion Criteria:\n\n* Pregnancy\n* Congenital immunodeficiency;\n* HIV infection with the lymphocyte CD4 count below 200\u002Fmm3 or unknown in the last year;\n* Acute hematologic malignancy;\n* Neutropenia (\\\u003C1 leucocyte\u002FmL or \\\u003C 0.5 neutrophil\u002FmL);\n* Immunosuppressive drugs within the previous 30 days, including anti-cancer - Chemotherapy and anti-rejection drugs for organ\u002Fbone marrow transplant\n* Corticosteroids ≥ 20 mg\u002Fd of prednisone equivalent for more than 14 days\n* Known allergy to beta-lactams\n* Moribund patient or death expected from underlying disease during the current admission;\n* Patient deprived of liberty or under legal protection measure;\n* Participation in another interventional trial.\n\nExclusion criteria :\n\n* mPCR non available",{"count":58,"type":22},124,"INTERVENTIONAL",[61],"PHASE4","Assess the impact of a strategy combining respiratory mPCR and algorithm-based therapy developed using local epidemiology on the early optimization of initial antibiotic therapy for ventilator-associated pneumonia (VAP) (intervention), compared to a conventional strategy (control).\n\nA bicentric, parallel-group, randomized controlled trial. The primary assessment criterion is the proportion of early optimized antibiotic therapy within 24 hours of respiratory sampling.",[28],[65,66,67],"mPCR","ventilator associated pneumonia","algorithm-based therapy","NOT_YET_RECRUITING","2026-02-11",{"date":71,"type":40},"2026-02-12",{"date":73,"type":22},"2026-06-01",{"date":75,"type":22},"2026-07-31",{"name":77,"class":47},"Centre Hospitalier Universitaire de Nīmes",{"id":79,"slug":80,"hasResults":11,"nctId":81,"briefTitle":82,"officialTitle":82,"acronym":83,"eligibilityCriteria":84,"healthyVolunteers":11,"sex":18,"minAge":85,"maxAge":86,"enrollmentInfo":87,"targetDuration":4,"studyType":24,"phases":4,"briefSummary":89,"conditions":90,"keywords":91,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":96,"lastUpdatePostDateStruct":97,"startDateStruct":99,"completionDateStruct":101,"leadSponsor":103,"locationsCount":48},"100594992","pre-clinical-diagnosis-using-integrated-microbial-and-host-response-signatures-to-improve-outcomes-from-ventilator-associated-pneumonia-in-critically-ill-children-100594992","NCT07026656","Pre-clinical Diagnosis Using Integrated Microbial and Host Response Signatures to Improve Outcomes From Ventilator-associated Pneumonia in Critically Ill Children","VAP-Dx","Inclusion Criteria:\n\n* PICU Admission\n* Requires 48 Hours Of Mechanical Ventilation\n\nExclusion Criteria:\n\n* Imminent death or palliative care pathway planned\n* Existing tracheostomy at time of admission\n* Known immunocompromised patient\n* Patient received a full course of systemic antimicrobials in the previous 6 weeks.\n* Known or suspected tuberculosis (TB).","1 Month","16 Years",{"count":88,"type":22},300,"Ventilator-associated pneumonia (VAP), defined as pneumonia occurring 48 hours after initiation of invasive mechanical ventilation, is insidious in onset and severe in consequence. It is a critical issue affecting 10-20% of the 26,000 children admitted to the paediatric intensive care unit (PICU) each year. Infection typically leads to extended PICU stay, prolonged invasive mechanical ventilation, and increased mortality.\n\nDespite its clinical significance, VAP remains poorly defined, as current diagnosis relies on non-specific criteria and the ability to obtain clinically meaningful cultures. VAP, deviates from conventional pneumonia, potentially originating, from tissue damage, changes to immune processes, and migration of gastrointestinal bacteria into the lung; all associated with prolonged mechanical ventilation. These factors, in combination with the clinical instability of PICU patients, mean that clinicians aggressively start antibiotic therapy despite a paucity of evidence to suggest the best regime. As a result, suspected VAP has been shown to account for nearly 40% of antibiotic exposure in the PICU, which has significant implications on anti-microbial resistance (AMR).\n\nTo address these challenges, novel diagnostic therapies are needed to optimise the treatment of VAP. These therapies should utilise our current understanding of the pathophysiology of VAP development, specifically, the infiltration of the lung microbiome by gut and oral bacteria during prolonged mechanical ventilation. To achieve this, molecular testing should be promoted allowing for rapid identification of lung pathogens. There is also growing evidence, for the investigation of predictive biomarkers for VAP available in both the blood and lungs, which when integrated into protocols may enhance diagnostic accuracy. These novel techniques may improve clinical outcomes for affected children while addressing the economic impact of prolonged hospital stays and mitigating AMR risks in PICUs.",[28],[92,93,94,95],"Respiratory Tract Infection","Immunology","Genomics","Paediatric Intensive Care Unit (PICU)","2025-07-30",{"date":98,"type":40},"2025-08-03",{"date":100,"type":40},"2025-04-14",{"date":102,"type":22},"2027-09-30",{"name":104,"class":47},"University of Cambridge"]