[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"ventilator-associated-pneumonia\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:ventilator-associated-pneumonia":32},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,19,0,[8,51,87,114,145,170,202,230,260,295,325,345,375,396,417,443,468,490,515],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":34,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":39,"lastUpdatePostDateStruct":40,"startDateStruct":43,"completionDateStruct":45,"leadSponsor":47,"locationsCount":50},"100524838","phase-4-prevention-of-infection-of-the-respiratory-tract-through-application-of-non-invasive-methods-of-secretion-suctioning-100524838",false,"NCT06113939","Prevention of Infection of the Respiratory Tract Through Application of Non-Invasive Methods of Secretion Suctioning","Prevention of Infection of the Respiratory Tract by Applying Methods That Are Non-Invasive for Extraction of Secretions. An Open Label, Randomized, Assessor-blinded, Pilot Trial.","PIRAMIDES","Inclusion criteria\n\n1. Endotracheal intubation with an anticipated duration \\> 48 hours.\n2. High risk of early respiratory infection associated with a diagnosis of:\n\n   1. Severe trauma.\n   2. Severe traumatic brain injury.\n   3. Ischaemic or haemorrhagic stroke.\n   4. Other causes of impaired consciousness: post-resuscitated cardiac arrest status, intoxications, acute infections or diseases of the central nervous system, seizures.\n3. Informed consent signed by the patient or, when impossible due to clinical status, by their legal representative, with re-consent by the patients themselves upon regaining capacity (section 15).\n\nExclusion criteria\n\n1. Intubation with an anticipated duration \\\u003C 48 hours.\n2. Foreseeable ominous prognosis within \\\u003C 7 days.\n3. Already established indication for systemic antibiotic therapy, either for suspected aspiration pneumonia with radiological pulmonary infiltrate or for suspected non-respiratory source infection.\n4. Active haemoptysis or pulmonary haemorrhage.\n5. Unstable chest.\n6. Undrained pneumothorax (inclusion may be considered once drained).\n7. Known allergy or intolerance to beta-lactam antibiotics.","ALL","18 Years",{"count":20,"type":21},60,"ESTIMATED","INTERVENTIONAL",[24],"PHASE4","Adults who are unconscious or severely ill and need a breathing tube connected to a ventilator are at high risk of developing a lung infection (pneumonia) within the first few days in the intensive care unit. This early pneumonia affects up to 30 to 50 % of certain high-risk patients, prolongs the time on the ventilator and in hospital, and increases the use of antibiotics.\n\nTwo strategies are commonly used today to try to prevent this infection: a short, three-day course of an intravenous antibiotic, and removal of secretions from the airway with a sterile suction catheter. Both have limitations - antibiotics can favour the growth of resistant bacteria, and catheter suctioning is uncomfortable and may injure the airway.\n\nPIRÁMIDES is a small (60-patient) pilot study that compares the current practice with two non-invasive, mechanical alternatives for keeping the airway clear: a continuous low-pressure suction system built into a special breathing tube, and a device that produces a gentle, programmed \"artificial cough\" through the ventilator. Adult patients who are intubated for severe trauma, severe brain injury, stroke, resuscitated cardiac arrest or other causes of decreased consciousness are randomly assigned, in equal numbers, to one of the three approaches and followed for 14 days, with a final visit at day 90.\n\nThe main goal is to find out which of the three strategies best prevents early pneumonia, and which provides the best overall result for patients when survival, severity of infection, need for additional antibiotics and side effects are considered together. To make these comparisons as fair as possible in an open-label study, an independent committee of doctors not involved in patient care reviews each suspected pneumonia case without knowing which strategy the patient received. The results will help design a larger trial to confirm which approach is safest and most effective for preventing early pneumonia in critically ill patients on a ventilator.",[27,28,29,30,31,32,33],"Intubation Complication","Stroke, Ischemic","Stroke Hemorrhagic","Head Trauma","Cardiac Arrest","Ventilator Associated Pneumonia","Airway Clearance Impairment",[35,36,37],"ventilator-associated pneumonia","prevention","airway clearance","NOT_YET_RECRUITING","2026-06-25",{"date":41,"type":42},"2026-06-29","ACTUAL",{"date":44,"type":21},"2026-09-15",{"date":46,"type":21},"2029-06-30",{"name":48,"class":49},"Hospital San Carlos, Madrid","OTHER",1,{"id":52,"slug":53,"hasResults":11,"nctId":54,"briefTitle":55,"officialTitle":56,"acronym":57,"eligibilityCriteria":58,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":59,"targetDuration":4,"studyType":22,"phases":61,"briefSummary":63,"conditions":64,"keywords":67,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":77,"lastUpdatePostDateStruct":78,"startDateStruct":80,"completionDateStruct":82,"leadSponsor":84,"locationsCount":86},"100644125","phase-3-inhaled-amikacin-versus-placebo-in-patients-with-ventilator-associated-tracheobronchitis-100644125","NCT07665788","Inhaled Amikacin Versus Placebo in Patients With Ventilator-associated Tracheobronchitis","A Multicentre, Double-blind, Randomized Controlled Trial of Inhaled Amikacin Versus Placebo in Critically Ill Patients With Ventilator-associated Tracheobronchitis","AMIVAT","Inclusion criteria:\n\n* Age ≥ 18 years\n* Admission to a participating intensive care unit (ICU)\n* Invasive mechanical ventilation \\> 48 hours\n* First episode of ventilator-associated tracheobronchitis during the ICU stay defined using the following criteria: (i) purulent tracheobronchial secretions, (iii) no new or progressive persistent pulmonary infiltrate on chest X-ray, and (iv) bacterial growth on endotracheal aspirate ≥10.5 colony-forming unit (CFU)\u002FmL or on bronchoalveolar lavage ≥10.4 CFU\u002FmL or on plugging telescopic catheter ≥10.3 CFU\u002FmL\n* Coverage by the French health insurance system (Social Security)\n* Written informed consent obtained from the patient, or, if the patient is not able to give written consent, from his or her legally designated representative (trusted person designated by the patient or, failing that, a family member) or, failing that, inclusion performed by the investigator within the therapeutic window (in such cases, informed consent will be sought by the investigator from the patient, or his or her legally designated representative, whichever is sooner). In all cases, the patient's written informed consent will be obtained as soon as possible.\n* For woman of childbearing potential: negative pregnancy test result at the time of inclusion\n\nExclusion criteria:\n\n* Previous ventilator-associated pneumonia due to the pathogens responsible for ventilator-associated tracheobronchitis during the same ICU stay\n* On-going antimicrobial therapy fpr ventilator-associated pneumonia\n* Ventilator-associated tracheobronchitis due to pathogens with intrinsic amikacin resistance (e.g. Stenotrophomonas maltophilia)\n* On-going therapy with intravenous amikacin or another aminoglycoside\n* Acute kidney injury stage 2 or 3 of the Kidney Disease Improving Global Outcomes (KDIGO) classification and\u002For advanced chronic kidney failure (glomerular filtration rate \\\u003C30 mL\u002Fmin), except in patients under renal replacement therapy\n* Grade B or C cirrhosis (Child-Pugh classification)\n* Scheduled extubation within 24h\n* Prior tracheotomy\n* Administration of inhaled antibiotics within the 7 preceding days\n* Known hypersensitivity to amikacin, another aminoglycoside, or any of the excipients\n* Myasthenia gravis\n* Contraindication to nebulization\n* On-going treatment with ataluren\n* Persons covered by articles L1121-5 to L1121-8 of the French Public Health Code (corresponding to all protected persons: pregnant women, parturients, nursing mothers, persons deprived of their liberty by judicial or administrative decision, minors, and persons subject to a legal protection measure: guardianship or trusteeship).\n* Moribund patient\n* End-of-life decision\n* Previous inclusion in the present study\n* Participation to another interventional study\n* Inability of the patient, or the person providing consent, to understand all aspects of the research\n* Patient being a relative of the investigator or a relative of someone from the team directly involved in the trial, including doctors and pharmacists",{"count":60,"type":21},250,[62],"PHASE3","The primary objective of the AMIVAT trial is to assess whether a 5-day course of inhaled amikacin, compared to placebo, reduces the incidence of progression to ventilator-associated pneumonia (VAP) at day 28 in intensive care unit (ICU) patients with ventilator-associated tracheobronchitis (VAT). Transition from VAT to VAP will be defined as the occurrence of a first VAP episode due to the same pathogens than those responsible for VAT.",[65,66],"Ventilator-Associated Pneumonia","Ventilator-Associated Tracheobronchitis",[68,69,70,71,72,73,74,75,76],"Ventilator-associated tracheobronchitis","Ventilator-associated pneumonia","Inhaled antimicrobial therapy","Mechanical ventilation","Hospital-acquired infection","Ventilator-associated lower respiratory tract infection","ICU-acquired infection","Aminoglycoside","Amikacin","2026-06-18",{"date":79,"type":42},"2026-06-24",{"date":81,"type":21},"2026-06-01",{"date":83,"type":21},"2029-09-01",{"name":85,"class":49},"University Hospital, Tours",17,{"id":88,"slug":89,"hasResults":11,"nctId":90,"briefTitle":91,"officialTitle":92,"acronym":93,"eligibilityCriteria":94,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":95,"targetDuration":4,"studyType":97,"phases":4,"briefSummary":98,"conditions":99,"keywords":101,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":105,"lastUpdatePostDateStruct":106,"startDateStruct":108,"completionDateStruct":110,"leadSponsor":112,"locationsCount":4},"100626526","b-lymphocyte-populations-in-the-pulmonary-microenvironment-of-patients-under-mechanical-ventilation-with-or-without-vap-ventilator-associated-pneumonia-100626526","NCT07436780","B Lymphocyte Populations in the Pulmonary Microenvironment of Patients Under Mechanical Ventilation With or Without VAP (Ventilator-Associated Pneumonia)","Pilot Study Describing B Lymphocyte Populations in the Pulmonary Microenvironment of Patients Under Mechanical Ventilation With or Without VAP (Ventilator-Associated Pneumonia)","OLYMPE","Inclusion Criteria:\n\n* Adult patients (≥18 years old), admitted to intensive care under mechanical ventilation for an estimated duration of at least 5 days.\n\nExclusion Criteria:\n\n* Patients admitted for an infectious pneumonia or presenting with acute respiratory distress syndrome (ARDS). Patients in aplasia (leukocytes \\\u003C 0.5 gigal\u002FL).",{"count":96,"type":21},75,"OBSERVATIONAL","Diagnosis of VAP relies on a set of non-specific clinical, biological, and imaging criteria.\n\nUnderstanding host-pathogen interactions and the mechanisms of deregulations leading to infection of pulmonary tissue appears essential.\n\nThe aim is to qualitatively describe the B lymphocyte populations present in the pulmonary microenvironment of patients admitted to intensive care and requiring invasive mechanical ventilation",[100],"Ventilator-associated Pneumonia",[35,102,103,104],"Intensive care medicine","host-pathogen interaction","humoral immunity","2026-02-23",{"date":107,"type":42},"2026-02-27",{"date":109,"type":21},"2026-01-31",{"date":111,"type":21},"2027-07-30",{"name":113,"class":49},"University Hospital, Limoges",{"id":115,"slug":116,"hasResults":11,"nctId":117,"briefTitle":118,"officialTitle":119,"acronym":120,"eligibilityCriteria":121,"healthyVolunteers":11,"sex":17,"minAge":122,"maxAge":123,"enrollmentInfo":124,"targetDuration":4,"studyType":22,"phases":126,"briefSummary":128,"conditions":129,"keywords":130,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":136,"lastUpdatePostDateStruct":137,"startDateStruct":139,"completionDateStruct":141,"leadSponsor":143,"locationsCount":4},"100553646","phase-2-nebulised-colistimethate-sodium-to-prevent-pediatric-ventilator-associated-pneumonia-100553646","NCT06488794","Nebulised Colistimethate Sodium to Prevent Pediatric Ventilator-associated Pneumonia","Nebulised Colistimethate Sodium to Prevent Pediatric Ventilator-associated Pneumonia: The COLIPED Investigation","ColiPed","Inclusion Criteria:\n\n* Children older than 1 month and younger than 14 years\n* Patients on invasive mechanical ventilation for more than 48 hours\n* Informed parental consent\n\nExclusion Criteria:\n\n* Suspected or confirmed VAP on the day of inclusion\n* Indication for systemic colistin therapy before or at enrolment in the study\n* Plan for extubation within the next 24H\n* Known allergy to colistin\n* No parental consent\n* Tracheostomy\n* Appearance of allergic clinical manifestations in the days of colistin nebulization\n* Appearance of undesirable clinical or biological manifestations presumed attributable to nebulization with colistin","1 Month","14 Years",{"count":125,"type":21},400,[127,62],"PHASE2","The goal of this clinical trial is to learn if nebulized colistimethate sodium can prevent pneumonia in ventilated children. The main question it aims to answer is:\n\n• Does nebulized colistimethate sodium lower the number of times participants develop ventilation associated pneumonia? Researchers will compare nebulized colistimethate sodium to a placebo (a look-alike substance that contains no drug) to see if nebulized colistin works to prevent ventilation associated pneumonia in children.\n\nParticipants will:\n\n* Take nebulized colistimethate sodium or a placebo twice a day for a maximum of 7 days.\n* Will be followed to check for pneumonia occurrence while they are on mechanical ventilation.",[32],[131,132,133,134,36,135],"colistin","mechanical ventilation","pneumonia","nebulization","pediatrics","2026-02-20",{"date":138,"type":42},"2026-02-24",{"date":140,"type":21},"2027-01-01",{"date":142,"type":21},"2028-12-31",{"name":144,"class":49},"University Hospital Fattouma Bourguiba",{"id":146,"slug":147,"hasResults":11,"nctId":148,"briefTitle":149,"officialTitle":150,"acronym":4,"eligibilityCriteria":151,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":152,"enrollmentInfo":153,"targetDuration":4,"studyType":22,"phases":155,"briefSummary":157,"conditions":158,"keywords":4,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":161,"lastUpdatePostDateStruct":162,"startDateStruct":164,"completionDateStruct":166,"leadSponsor":168,"locationsCount":50},"100498239","macrophage-programing-in-acute-lung-injury-minibal-100498239","NCT05767671","Macrophage Programing in Acute Lung Injury: MiniBAL","Macrophage Programing in Acute Lung Injury","Inclusion Criteria:\n\n* Written informed consent (by LAR if subject unconscious or has altered mental status) prior to any study procedures. Verbal consent may be used as necessary\n* Adults greater than 18 years of age\n* Admission to the intensive care unit.\n* Orally\u002Fnasally intubated or expected to be intubated within 48 hours\n\nExclusion Criteria:\n\n* History of solid organ or bone marrow transplantation\n* Severe or massive hemoptysis\n* At significant risk for bleeding (INR \\> 3 or PTT \\> 3x normal)\n* Presence of pneumomediastinum or pneumothorax on recent imaging\n* Presence of an advanced directive with Do Not Intubate (DNI) status (Do Not Resuscitate (DNR) is acceptable)\n* Morbid state or expected to survive less than 24 hours because of an advanced co-morbid medical condition in the opinion of the PI and\u002For clinical team and attending physician.\n* Pregnancy","99 Years",{"count":154,"type":21},56,[156],"NA","The goal of this observational clinical trial is to learn about the role white blood cells (macrophages) play in lung inflammation in people with Acute Respiratory Distress Syndrome (ARDS). The main questions it aims to answer are:\n\n1. How does the immune system respond to different kinds of lung injury and inflammation and how do those processes differ from each other?\n2. What roles do the cells that live in the lungs (macrophages) play in turning off inflammation? How does their role differ from other cells that are called to the lung to help repair injury (recruited macrophages)?\n3. Will more frequent testing of lung cell samples help reduce the time it takes to start treatment for ventilator-associated pneumonia (VAP) and therefore reduce the rates of initial therapy failure?\n\nParticipants will be in the intensive care unit (ICU) on a mechanical ventilator (machine that helps patients breathe) because they have ARDS or are on a mechanical ventilator for some other reason (control group). The following will happen:\n\n1. Participants will be given 100% oxygen through the breathing machine (mechanical ventilator) for 3-5 minutes. This is called pre-oxygenation.\n2. A lung specialist (pulmonologist), a member of Dr. Janssen's research team, or respiratory therapist will place small amount of saline into the lung using a long catheter going through the breathing tube.\n3. The fluid will be removed with suction and will be sent to the laboratory for testing.\n4. This will be repeated two more times over the course of 10 days, or less if participants are taken off of the ventilator. The procedure will be performed no more than three times.\n5. Two nasal brushings will be taken from the participants' nose.\n6. Approximately 3 tablespoons of blood will be removed by putting a needle into the participants vein. This is the standard method used to obtain blood for tests. A total of 9 tablespoons will be taken for research purposes over the course of this study\n7. Data including the participants age, sex, severity of illness, and other medical conditions will be recorded to determine how these can affect the white blood cells.\n8. If bacteria are isolated from the fluid in the participants lung, the participants' physician may choose to place the participants on antibiotics to treat an infection.\n9. A follow-up phone call may be made by a member of the research team after discharge from the hospital. At this time, the participant may be invited to participate in the Post-ICU clinic at National Jewish Health.",[159,32],"Acute Respiratory Distress Syndrome","RECRUITING","2026-02-05",{"date":163,"type":42},"2026-02-06",{"date":165,"type":42},"2020-04-10",{"date":167,"type":21},"2027-12-30",{"name":169,"class":49},"William Janssen, MD",{"id":171,"slug":172,"hasResults":11,"nctId":173,"briefTitle":174,"officialTitle":175,"acronym":4,"eligibilityCriteria":176,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":177,"targetDuration":4,"studyType":22,"phases":179,"briefSummary":180,"conditions":181,"keywords":186,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":192,"lastUpdatePostDateStruct":193,"startDateStruct":195,"completionDateStruct":197,"leadSponsor":199,"locationsCount":4},"100613772","optimizing-enteral-nutrition-regimen-for-critically-ill-patients-100613772","NCT07270939","Optimizing Enteral Nutrition Regimen for Critically Ill Patients","Optimizing Enteral Nutrition: A Comparative Study of 18-Hour, 20-Hour, and 24-Hour","Inclusion Criteria\n\nParticipants must meet ALL of the following criteria to be eligible for the study:\n\n1. Patients aged ≥ 18 years.\n2. Patients expected to require enteral nutrition (EN) for ≥ 7 days.\n3. Critically ill, mechanically ventilated patients in the ICU.\n4. New patients initiating EN in the critical care unit.\n5. Patients receiving EN via:\n\n   * a nasogastric (NG) tube.\n   * orogastric (OG) feeding tube.\n\nExclusion Criteria:\n\n1. Patients with contraindications to enteral feeding or pre-existing gastrointestinal disorders, including:\n\n   * Active GI bleeding.\n   * Progressive GI disease.\n   * Recent GI tract resection.\n2. Indication for a special diet formula.\n3. Need for a large volume of feeding (as determined by the clinical team).\n4. Pre-existing hepatic failure.\n5. Use of a nasojejunal tube, gastrostomy, or jejunostomy.\n6. Pregnancy confirmed via β-hCG testing for women of childbearing potential.\n7. Insulin-dependent diabetes mellitus.",{"count":178,"type":21},150,[156],"Clinical Trial The goal of this clinical trial is to learn whether different enteral feeding cycles (18-hour, 20-hour, or standard 24-hour continuous feeding) improve outcomes for critically ill ICU patients who need tube feeding. It will also look at tolerance, nutrition delivery, and safety.\n\nThe main questions it aims to answer are:\n\nDo shorter feeding cycles (with fasting windows) reduce ICU length of stay?\n\nDo they lower the risk of infections like ventilator-associated pneumonia?\n\nHow do they affect calorie delivery, blood sugar control, and gastrointestinal tolerance?\n\nResearchers will compare:\n\nContinuous 24-hour feeding (standard care)\n\n20-hour feeding with a 4-hour fasting window\n\n18-hour feeding with a 6-hour fasting window\n\nParticipants will:\n\nBe critically ill adults in the ICU who require at least 7 days of enteral feeding\n\nBe randomized to one of the three feeding schedules\n\nReceive daily monitoring of calories, protein, blood sugar, and GI tolerance\n\nHave outcomes measured, including ICU length of stay, infections, metabolic control, and feeding tolerance",[182,183,32,184,185],"Critical Illness","Enteral Nutrition","Hyperglycemia","Feeding Intolerance",[187,188,189,190,191],"Cyclic feeding","Feeding window","Critical care nutrition","Gastrointestinal tolerance","Nutritional adequacy","2025-11-26",{"date":194,"type":42},"2025-12-08",{"date":196,"type":21},"2025-12-30",{"date":198,"type":21},"2026-11-30",{"name":200,"class":201},"Hamad Medical Corporation","INDUSTRY",{"id":203,"slug":204,"hasResults":11,"nctId":205,"briefTitle":206,"officialTitle":206,"acronym":207,"eligibilityCriteria":208,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":209,"targetDuration":4,"studyType":22,"phases":211,"briefSummary":212,"conditions":213,"keywords":215,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":221,"lastUpdatePostDateStruct":222,"startDateStruct":224,"completionDateStruct":226,"leadSponsor":228,"locationsCount":50},"100466518","hydrocortisone-versus-placebo-for-severe-hospital-acquired-pneumonia-in-intensive-care-patients-the-hydro-ship-study-100466518","NCT05354778","HYDROcortisone Versus Placebo for Severe HospItal-acquired Pneumonia in Intensive Care Patients: the HYDRO-SHIP Study","HYDRO-SHIP","Inclusion Criteria:\n\n* 18 years of age or older\n* Suspected ou confirmed case of bacterial nosocomial pneumonia (including ventilator-associated pneumonia)\n* Intensive Care Unit stay\n* Signed consent form (by the patient or a legal guardian)\n\nExclusion Criteria:\n\n* Women who are pregnant, have recently given birth or are breastfeeding\n* Patients who are moribund or do not have a treatment perspective\n* Patients with community acquired pneumonia\n* Patients with other types of pneumonia (viral - including COVID-19, fungal etc.)\n* Those with pulmonary infiltrates in chest image which are not compatible with bacterial pneumonia\n* Patients with adrenal insufficiency\n* Patients who have a condition that demands the use of corticosteroids (acute or chronic)\n* Patients allergic to hydrocortisone\n* Patients with refractory septic shock (those receiving more than 0,5mcg\u002Fkg\u002Fmin of norepinephrine)",{"count":210,"type":21},180,[156],"The use of corticosteroids in patients with severe community pneumonia, bacterial infection which kills lots of patients around the world, reduces the mortality of this infection. However, there are no studies with this type of drug regarding hospital-acquired pneumonia. This is the first multicenter randomized trial to test hydrocortisone plus standard therapy in critical care patients with nosocomial pneumonia. This intervention is inexpensive and may improve the outcome of those patients, besides having an acceptable side effects profile.",[214,32],"Healthcare-Associated Pneumonia",[216,217,218,219,220],"Hydrocortisone","Intensive Care Unit","Pneumonia","Steroids","Critical Care","2025-11-22",{"date":223,"type":42},"2025-11-25",{"date":225,"type":42},"2022-10-16",{"date":227,"type":21},"2027-02",{"name":229,"class":49},"Instituto de Assistencia Medica ao Servidor Publico Estadual, Sao Paulo",{"id":231,"slug":232,"hasResults":11,"nctId":233,"briefTitle":234,"officialTitle":235,"acronym":236,"eligibilityCriteria":237,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":238,"targetDuration":4,"studyType":22,"phases":240,"briefSummary":241,"conditions":242,"keywords":247,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":250,"lastUpdatePostDateStruct":251,"startDateStruct":253,"completionDateStruct":255,"leadSponsor":257,"locationsCount":259},"100526419","phase-3-acyclovir-in-ventilated-patients-with-pneumonia-and-hsv-1-in-bal-100526419","NCT06134492","Acyclovir in Ventilated Patients With Pneumonia and HSV-1 in BAL","Effect of Acyclovir Therapy on the Outcome of Ventilated Patients With Lower Respiratory Tract Infection and Detection of Herpes Simplex Virus in Bronchoalveolar Lavage","HerpMV","Inclusion Criteria:\n\n1. ≥ 18 years\n2. need for invasive or non-invasive respiratory support\n3. PCR HSV-1 detection in BAL (≥ 10\\^3 copies\u002Fml)\n4. Pneumonia (community or healthcare acquired, incl. ventilator-associated pneumonia)\n5. declaration of consent by the patient or legal representative\n\nExclusion Criteria:\n\n1. History of hypersensitivity to acyclovir or valacyclovir or other components of the investigational product.\n2. Pregnancy\u002FLactation\n3. Simultaneous participation in another interventional clinical trial\n4. Decision to withhold life-sustaining therapies\n5. Use of a virostatic agent (i.v. or p. os) with activity against herpes simplex (acyclovir, valacyclovir, famciclovir\u002Fpenciclovir, brivudine, cidofovir, foscarnet) for therapeutic or prophylactic reasons at the time of randomization.\n6. Solid organ transplantation, stem cell transplantation\n7. Neutropenia (absolute neutrophil count \\\u003C1500\u002Fμl (\\\u003C1.5 × 109 \u002Fl)\n8. Previous study participation in HerpMV",{"count":239,"type":21},616,[62],"Almost 90 out of 100 people carry herpes simplex viruses (HSV). Once a person has been infected with the herpes viruses, he or she can't get rid of them for the rest of her\u002Fhis life. For the most part, the viruses are in a dormant state. Only when the immune system is weakened, for example in the case of a serious illness or stress, are the viruses reactivated. They then mainly cause cold sores, which are harmless for healthy people and usually heal without therapy. However, especially in people with a weakened immune system, HSV can also cause serious infections, such as meningitis. In almost every second mechanically ventilated patient in intensive care who has pneumonia, HSV can be detected in the respiratory tract. This is caused by reactivation of the viruses as a result of the severe underlying disease and stress during intensive care therapy. Whether treatment of the herpes viruses (e.g. with acyclovir) is necessary in this situation and helps the patients to cure has not been clarified, especially as acyclovir can also cause side effects such as a deterioration in kidney function. Currently, the physicians decide to treat the herpes viruses in about half of the patients. Several studies have shown that patients for whom the physician decided to treat the viruses survived more often. However, all of these studies looked at the course of the disease only retrospectively and thus are subject to many biases (including physician selection of who receives treatment, missing data). A definitive conclusion as to whether herpesvirus therapy can be recommended cannot be drawn without doubt from these studies. Therefore, the investigators would like to investigate in a randomized controlled trial, i.e. patients are randomly assigned to the experimental (therapy of herpesviruses) or control group (no therapy of herpesviruses), the effect of therapy with acyclovir on survival in ventilated intensive care patients with lower respiratory tract infection (pneumonia) in whom a large amount of HSV was found in the respiratory tract. The goal of the study is to provide clarity on whether therapy will help patients recover.",[243,32,244,245,246],"Pneumonia, Viral","Community-acquired Pneumonia","Herpes Simplex","Hospital-acquired Pneumonia",[218,245,248,249],"Mechanical Ventilation","Aciclovir","2025-11-18",{"date":252,"type":42},"2025-11-21",{"date":254,"type":42},"2024-02-20",{"date":256,"type":21},"2026-12",{"name":258,"class":49},"Jena University Hospital",28,{"id":261,"slug":262,"hasResults":11,"nctId":263,"briefTitle":264,"officialTitle":265,"acronym":266,"eligibilityCriteria":267,"healthyVolunteers":268,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":269,"targetDuration":271,"studyType":97,"phases":4,"briefSummary":272,"conditions":273,"keywords":281,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":286,"lastUpdatePostDateStruct":287,"startDateStruct":289,"completionDateStruct":291,"leadSponsor":293,"locationsCount":50},"100484735","early-severe-illness-translational-biology-informatics-in-humans-100484735","NCT05591924","Early Severe Illness TrAnslational BioLogy InformaticS in Humans","Prospective Observational Study of Biology of Critical Illness","ESTABLISH","Inclusion Criteria:\n\n* Age ≥18 years old\n* ≤48h since ICU admission\n* ICU admission within 72h of presentation to the emergency department (ER)\n* Clinical critical illness suspected on the basis of any one of the following:\n\n  1. Altered mental status (GCS\\\u003C15)\n  2. Cardiovascular collapse (presence of any: Heart rate \\>90, systolic blood pressure \\\u003C90, presence of vasopressors, lactate \\>2.0)\n  3. Respiratory collapse (presence of any: respiratory rate \\>20, PaCO₂ \\\u003C32 mm Hg, supplemental oxygen, invasive or non-invasive ventilation)\n  4. Suspected severe infection (presence of any: temperature \\>38°C or \\\u003C36°C, white blood cell (WBC) count \\>12,000\u002Fmm³ or \\\u003C4,000\u002Fmm³, presence of 1 or more antibiotics at the time of ICU admission)\n\nExclusion Criteria:\n\n* Age \\\u003C18 years old\n* \\>72h since ICU admission\n* Admission to ICU in patients \\>72h after the presentation to the ER\n* No evidence of critical illness (ICU admission due to bed-spacing)",true,{"count":270,"type":21},1000,"24 Months","Advanced stages of the response to life-threatening infection, severe trauma, or other physiological insults often lead to exhaustion of the homeostatic mechanisms that sustain normal blood pressure and oxygenation. These syndromic presentations often meet the diagnostic criteria of sepsis and\u002For the acute respiratory distress syndrome (ARDS), the two most common syndromes encountered in the intensive care unit (ICU). Although critical illness syndromes, such as sepsis and ARDS, have separate clinical definitions, they often overlap clinically and share several common injury mechanisms. Moreover, there are no specific therapies for critically ill patients, and as a consequence, approximately 1 in 4 patients admitted to the ICU will not survive.\n\nThe purpose of this observational study is to identify early patient biologic factors that are present at the time of ICU admission that will help diagnose critical illness syndromes earlier, identify who could benefit most from specific therapies, and enable the discovery of new treatments for syndromes such as sepsis and ARDS.",[274,275,182,276,277,32,278,279,280],"Sepsis","ARDS","Neurocognitive Dysfunction","Shock, Septic","Immune Suppression","Inflammation","SIRS",[220,274,275,279,282,283,284,285],"Immune responses","Neurocognition","Critical illness","Translational Biology","2025-10-01",{"date":288,"type":42},"2025-10-06",{"date":290,"type":42},"2024-04-26",{"date":292,"type":21},"2034-12-31",{"name":294,"class":49},"London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's",{"id":296,"slug":297,"hasResults":11,"nctId":298,"briefTitle":299,"officialTitle":300,"acronym":301,"eligibilityCriteria":302,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":303,"enrollmentInfo":304,"targetDuration":4,"studyType":22,"phases":306,"briefSummary":307,"conditions":308,"keywords":309,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":315,"lastUpdatePostDateStruct":316,"startDateStruct":318,"completionDateStruct":320,"leadSponsor":322,"locationsCount":324},"100523202","probiotics-to-actively-counter-ventilator-associated-pneumonia-proact-100523202","NCT06092554","Probiotics to Actively Counter Ventilator Associated Pneumonia (PROACT)","Probiotics in ICU to Reduce Ventilator-Associated Pneumonia: A Double-blind Multicentre Randomized Clinical Trial","PROACT","Inclusion Criteria:\n\n* adults aged 18-80 years\n* at least one of the following conditions: a) recent trauma involving head injury and at least one more organ system; b) stroke or brain hemorrhage without any sign of aspiration and lung infection\n* intubation and start of mechanical ventilation. This needs to start immediately after the event described in the inclusion criteria (b). For cases of head trauma this is defined as start in the ambulance or the emergency department\n* likelihood that the duration of mechanical ventilation would be at least six days\n* written informed consent provided by the patient or legal representative\n\nExclusion Criteria:\n\n* has received mechanical ventilation more than 72 hours from start of screening\n* pregnancy or Lactation\n* patients at risk of iatrogenic probiotic infection e.g. immunosuppression which includes\n* HIV \\\u003C200 CD4 cells\u002FμL\n* those receiving chronic immunosuppressive medications (e.g., azathioprine, cyclosporine, cyclophosphamide, tacrolimus, methotrexate, mycofenolate, Anti-IL2)\n* previous transplantation at any time\n* malignancy requiring chemotherapy in the last 3 months\n* neutropenia \\[absolute neutrophil count \\\u003C 500\\])\n* patients with a primary diagnosis of severe pancreatitis (Ranson score of 3 or more). Mild and moderate pancreatis is not excluded\n* ischemic bowel disease\n* oropharyngeal mucosal injury\n* inability to receive enteral medications\n* intent to withdraw advanced life support as per ICU doctor in charge\n* patients at risk of endovascular infection which includes\n\n  1. previously documented rheumatic heart disease, congenital valve disease, surgically repaired congenital heart disease, unrepaired cyanotic congenital heart disease, any intracardiac repair with prosthetic material \\[mechanical or bioprosthetic cardiac valves\\]\n  2. previous or current endocarditis\n  3. permanent endovascular devices (e.g., endovascular grafts \\[e.g., aortic aneurysm repair, stents involving large arteries such as aorta, femorals and carotids\\] inferior vena cava filters, dialysis vascular grafts\n  4. tunnelled (not short-term) hemodialysis catheters\n  5. pacemakers or defibrillators\n\n     Patients with peripherally inserted central catheters (PICCs), temporary central venous catheters, central venous dialysis catheters, coronary artery stents, coronary artery bypass grafts (CABG), or neurovascular coils are not excluded, nor are patients with mitral valve prolapse or bicuspid aortic valve if they do not meet any other exclusion criteria.\n* patients with sepsis and\u002For septic shock","80 Years",{"count":305,"type":21},186,[156],"PROACT study aims to resolve uncertainties to influence actual practice guidelines or public health policing regarding VAP prevention in ICU by using probiotics administration.\n\nMulti-trauma patients with a head injury OR stroke or brain haemorrhage patients without any sign of aspiration and lung infection will be enrolled and randomized to either placebo or probiotic treatment to assess if VAP and mortality can be reduced in the interventional group.",[32],[32,310,311,312,313,314],"Traumatic Brain Injury","stroke","probiotics","VAP","TBI","2025-09-17",{"date":317,"type":42},"2025-09-23",{"date":319,"type":42},"2023-12-13",{"date":321,"type":21},"2026-07-15",{"name":323,"class":49},"University of Bari",9,{"id":326,"slug":327,"hasResults":11,"nctId":328,"briefTitle":329,"officialTitle":329,"acronym":4,"eligibilityCriteria":330,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":331,"targetDuration":4,"studyType":22,"phases":333,"briefSummary":334,"conditions":335,"keywords":4,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":336,"lastUpdatePostDateStruct":337,"startDateStruct":339,"completionDateStruct":341,"leadSponsor":343,"locationsCount":50},"100600816","effect-of-a-constructivist-educational-program-on-preventing-ventilator-associated-pneumonia-in-intensive-care-units-100600816","NCT07102407","Effect of a Constructivist Educational Program on Preventing Ventilator-Associated Pneumonia in Intensive Care Units","Inclusion Criteria:\n\n* age \\> 18 years\n* patients receiving mechanical ventilation for more than 48 hours\n\nExclusion Criteria:\n\n* A clinical diagnosis of pneumonia at the time of admission",{"count":332,"type":21},51,[156],"This study is designed to investigate the impact of a constructivist education program on nurses and cleaning personnel regarding the preventive care bundle for the prevention of ventilator-associated pneumonia in the intensive care unit.",[32],"2025-08-17",{"date":338,"type":42},"2025-08-22",{"date":340,"type":42},"2025-08-15",{"date":342,"type":21},"2026-02-18",{"name":344,"class":49},"Karaman Training and Research Hospital",{"id":346,"slug":347,"hasResults":11,"nctId":348,"briefTitle":349,"officialTitle":350,"acronym":351,"eligibilityCriteria":352,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":353,"targetDuration":4,"studyType":22,"phases":355,"briefSummary":356,"conditions":357,"keywords":358,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":366,"lastUpdatePostDateStruct":367,"startDateStruct":369,"completionDateStruct":371,"leadSponsor":373,"locationsCount":50},"100558684","ventilator-associated-pneumonia-multiplex-pcr-for-anti-infective-regimens-100558684","NCT06554327","Ventilator Associated Pneumonia Multiplex PCR for Anti-Infective Regimens","Fast Multiplex PCR of Bronchoalveolar Lavage for Antibiotic Stewardship in Ventilator Associated Pneumonia. A Multicenter, Randomized Controlled Study","VAMPAIR","inclusion criteria :\n\n* Adult patients, hospitalized in intensive care unit\n* on mechanical ventilation for at least 48 hours\n* Suspected VAP\n* With an indication for bronchoalveolar lavage (BAL)\n\nexclusion criteria :\n\n* Patients under legal protection or without social security coverage\n* Pregnant women\n* Previous episode of VAP during the same hospitalization",{"count":354,"type":21},265,[156],"Ventilator-associated pneumonia (VAP) remains one of the main nosocomial infections acquired in the intensive care unit (ICU). VAP is pneumonia occurring 48 hours after intubation. Today, bronchoalveolar lavage (BAL) is used for microbiological diagnosis, with bacterial culture and antibiotic susceptibility results within 48 to 72 hours. Multiplex PCR can detect DNA of a number of bacteriae, as well as the presence of resistance genes. However, its clinical value in the ICU remains to be demonstrated. We think that the use of multiplex PCR with a panel adapted to the microbiology of VAP, could be an interesting method for clinicians in ICU.",[32],[359,360,361,362,363,364,365],"Ventilator associated pneumonia","Intensive care unit","Empirical antimicrobial therapy","Multiplex PCR","Diagnosis","Antibiotic stewardship","Bronchoalveolar lavage","2025-06-13",{"date":368,"type":42},"2025-06-17",{"date":370,"type":42},"2025-03-06",{"date":372,"type":21},"2026-10-06",{"name":374,"class":49},"CHU de Reims",{"id":376,"slug":377,"hasResults":11,"nctId":378,"briefTitle":379,"officialTitle":379,"acronym":380,"eligibilityCriteria":381,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":382,"targetDuration":4,"studyType":97,"phases":4,"briefSummary":384,"conditions":385,"keywords":4,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":388,"lastUpdatePostDateStruct":389,"startDateStruct":391,"completionDateStruct":393,"leadSponsor":394,"locationsCount":50},"100594297","inspiratory-work-of-breathing-before-and-after-extubation-100594297","NCT07017608","Inspiratory Work of Breathing Before and After Extubation","INTEGRATION","Inclusion Criteria:\n\n* Adult patients intubated and ventilated\n\nExclusion Criteria:\n\n* Contraindication for esophageal catheter insertion: upper gastrointestinal surgery within prior 6 weeks, actively bleeding esophageal varices\n* Bronchopleural fistula\n* Contraindication for electrical impedance tomography: chest burns, skin lesions in the thorax, chest wall bandaging limiting electrode placement, unstable spinal lesions or fractures\n* Pregnancy",{"count":383,"type":21},67,"Critically ill patients who (1) are not able to maintain their airway, (2) cannot breathe on their own, or (3) both, are ones who often require tracheal intubation and support from a breathing machine (mechanical ventilator). When the patient is ready to be liberated from the mechanical ventilator because the initial insult for intubation has been resolved, the patient is screened using the readiness to wean test in preparation for extubation. As the patient passes this screening, a spontaneous breathing test (SBT) is initiated. Currently, there are many debates surrounding which SBT technique is most favorable. At Toronto General Hospital, the clinical team uses a zero-end expiratory pressure (ZEEP) trial. Once the patient successfully passes their SBT they are then extubated.\n\nThe patient will undergo a spontaneous breathing trial of continuous positive airway pressure (CPAP) of 5 cmH2O and ZEEP, in which time the investigators will be using a new technology called electrical impedance tomography (EIT), to study and compare the end expiratory lung volume (EELV); investigators will use an esophageal catheter to measure and monitor pressures in the lung, and also assess the patient's work of breathing. This will be repeated once the patient has been extubated safely.",[386,387,32],"Lung Transplant; Complications","Ventilator-Induced Lung Injury","2025-06-03",{"date":390,"type":42},"2025-06-12",{"date":392,"type":42},"2020-09-01",{"date":256,"type":21},{"name":395,"class":49},"University Health Network, Toronto",{"id":397,"slug":398,"hasResults":11,"nctId":399,"briefTitle":400,"officialTitle":400,"acronym":401,"eligibilityCriteria":402,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":403,"targetDuration":4,"studyType":22,"phases":405,"briefSummary":406,"conditions":407,"keywords":4,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":408,"lastUpdatePostDateStruct":409,"startDateStruct":411,"completionDateStruct":413,"leadSponsor":415,"locationsCount":50},"100448862","antimicrobial-stewardship-for-ventilator-associated-pneumonia-in-intensive-care-100448862","NCT05124977","Antimicrobial Stewardship For Ventilator Associated Pneumonia in Intensive Care","ASPIC","Inclusion Criteria:\n\n* Diagnosis of microbiologically confirmed of first episode of VAP\n* Initial appropriate antibiotic therapy (whether empirical or not)\n* Written informed consent from the patient or a legal representative if appropriate. If absence of a legal representative the patient may be included in emergency procedure\n\nDefinitive diagnosis of pneumonia (in agreement with international guidelines) is defined by association:\n\n* Patient under MV\\>48 hours at the time of the microbiological sampling\n* New pulmonary infiltrate of which an infectious origin is strongly suspected\n* Worsening oxygenation\n* Have the following clinical criteria within the 24 hours prior to the first dose of antibiotic therapy\n\n  * Purulent tracheal secretions\n  * And at least 1 of the following : documented fever (body temperature \\>38,3°C) or hypothermia (body temperature \\\u003C35°C) or white blood cell (WBC) count \\>10,000 cells\u002Fmm3 or \\\u003C4,000 cells\u002Fmm3\n* Microbiological criteria (positive quantitative culture of a lower respiratory tract (LRT): bronchoalveolar lavage fluid (BAL) (significant threshold ≥10\\^4 colony-forming units\u002FmL) or plugged telescopic catheter (PTC) (significant threshold ≥ 10\\^3 colony-forming units\u002FmL) or quantitative endotracheal aspirate (ETA) distal pulmonary secretion samples (significant threshold ≥10\\^5 colony-forming units\u002FmL)\n\nExclusion Criteria:\n\n* Patient under selective decontamination of the digestive tract\n* Duration of antibiotic therapy prior to inclusion \\> 72h (for any reason) appropriate to the germs found in the bacterial documentation of the first episode of VAP\n* Inclusion in another interventional study concerning antimicrobial strategies\n* Moribund (IGS II\\>80)\n* Thoracic trauma with Abbreviated Injury Scale (AIS) thorax ≥ 3\n* Severely immunocompromised patients (such as congenital immunodeficiency, neutropenia (\\\u003C1leucocyte\u002Fml or \\\u003C0.5 neutrophil\u002Fml) or acute hematologic malignancy or stem cell transplant, HIV infection with CD4 count below 200\u002Fmm3\n* Patients undergoing immunosuppressive therapy and long term corticotherapy \\> 0.5 mg\u002Fkg\n* VAP due to: Pseudomonas aeruginosa, Carbapenem-resistant Acinetobacter spp, Carbapenem-resistant Enterobacteriaceae\n* VAP occurring in the context of co-infection of COVID-19 or other viral pneumonia (confirmed by RT-PCR)\n* Patients with empyema, necrotizing and abscessed pneumonia\n* Patients requiring extracorporeal oxygen therapy (ECMO), either veno-venous or veno-arterial\n* Pregnant women\n* No health insurance coverage",{"count":404,"type":21},590,[156],"Increasing emergence of multidrug resistant (MDR) bacteria worldwide is now considered one of the most urgent threats to global health. The association between increase of antibiotics consumption and resistance emergence has been well documented for all patients admitted to the Intensive care unit (ICU) who received antibiotic treatment and for patients treated for ventilator associated pneumonia (VAP).\n\nReduction of use of antibiotics is a major point in the war against antimicrobial resistance. VAP is the first cause of healthcare-associated infections in ICU and more than half of antibiotics prescriptions in ICU are due to VAP.\n\nOnce the diagnosis of pneumonia under MV has been made, initiation of antibiotic treatment must be prompt but there is no clear consensus on its duration. In the case of a good clinical response to treatment, it has been shown in some situations that short course antibiotics can be effective without side effects and antimicrobial stewardship initiatives can be applied successfully and effectively to the management of Community Acquired Pneumonia (CAP).\n\nThe hypothesis is that an antimicrobial stewardship is possible in the treatment of VAP with no increase in the rate of all-cause mortality, treatment failure or occurrence of new episode of pneumonia.\n\nThe objective is to investigate whether an antimicrobial stewardship for VAP based on daily assessment of clinical cure and antimicrobial discontinuation, if it is obtained, would be non-inferior in terms of all-cause mortality, treatment failure or occurrence of new episode of pneumonia.\n\nThis study will be a prospective, national multicenter (31 centers), phase III, comparative randomized (1:1), single-blinded clinical trial comparing two management strategies of treatment of pneumonia on the basis of two parallel arms:\n\nExperimental group: Antimicrobial stewardship based on daily clinical assessment of clinical cure.\n\nControl group: standard management: duration of appropriate antibiotic therapy for confirmed VAP according to guidelines.",[32],"2025-05-23",{"date":410,"type":42},"2025-05-25",{"date":412,"type":42},"2022-09-20",{"date":414,"type":21},"2026-03",{"name":416,"class":49},"Assistance Publique - Hôpitaux de Paris",{"id":418,"slug":419,"hasResults":11,"nctId":420,"briefTitle":421,"officialTitle":422,"acronym":423,"eligibilityCriteria":424,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":425,"targetDuration":4,"studyType":22,"phases":427,"briefSummary":428,"conditions":429,"keywords":430,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":434,"lastUpdatePostDateStruct":435,"startDateStruct":437,"completionDateStruct":439,"leadSponsor":441,"locationsCount":442},"100492741","phase-3-efficacy-of-cotrimoxazole-as-a-de-escalation-treatment-of-ventilator-associated-pneumonia-in-intensive-care-unit-100492741","NCT05696093","Efficacy of Cotrimoxazole as a De-escalation Treatment of Ventilator-Associated Pneumonia in Intensive Care Unit","Efficacy of Cotrimoxazole as a De-escalation Treatment of Ventilator-Associated Pneumonia in Intensive Care Unit. Multicentric Non-inferiority Randomised Controlled Trial","COTRIVAP","Inclusion Criteria:\n\n* Adult patients hospitalized in an ICU\n* Under mechanical ventilation for at least five days\n* Microbiologically confirmed VAP preferably on a distal lung sample (bronchoalveolar lavage or protected distal specimen) otherwise endotracheal aspiration\n* Enterobacteriaceae susceptible to cotrimoxazole, and for polymicrobial VAP, all bacteria susceptible to cotrimoxazole\n* 5\\) Treated for at least 24 hours by an appropriate empiric antibiotic therapy (at least one effective antibiotic from the initiation of treatment for this VAP episode), and for polymicrobial VAP, all bacteria susceptible to empiric antibiotic therapy\n* Stability of haemodynamic (stability or decrease in catecholamine dose) and respiratory (stability or improvement of FIO2) parameters\n\nExclusion Criteria:\n\n* Haemodynamic instability (increasing dose of a catecholamine in the last 24 hours)\n* Contra-indication to cotrimoxazole:\n\n  * allergy,\n  * advanced liver insufficiency,\n  * renal dysfunction with clearance \\\u003C15 mL\u002Fmin\u002F1.73 m² without hemodialysis\n  * G6PD deficiency\n  * history of hypersensitivity to one of the components (in particular, hypersensitivity to sulphonamides\n  * known macrocytic anemia defined by VGM \\>\n  * treatment with methotrexate\n* Infection requiring prolonged antibiotic-therapy (pleural empyema, lung abscess, necrotizing pneumonia, etc…)\n* Cystic fibrosis\n* Immunosuppression (neutropenia, HIV with CD4 lymphocytes below 200\u002Fmm3, immunosuppressive therapy or corticosteroid therapy \\>0.5 mg\u002Fkg\u002Fj before ICU admission)\n* Cardiac arrest without awakening\n* Moribund state (patient likely to die within 24h)\n* Limitation of life support (comfort care applied only) at the time of screening\n* Enrolment to another interventional study on VAP care\u002Fmanagement\n* Pregnancy or breastfeeding\n* Subject deprived of freedom, subject under a legal protective measure\n* No affiliation to any health insurance system\n* Refusal to participate to the study (patient or legal representative or family member or close relative if present)\n* Patients previously included in the study",{"count":426,"type":21},628,[62],"Efficacy of cotrimoxazole as a de-escalation treatment for adult patients Ventilator-Associated Pneumonia in intensive care unit Multicentre randomized non-inferiority trial comparing cotrimoxazole to standard antibiotic therapy for enterobacterial VAP",[32],[431,432,433,32],"intensive care unit","de-escalation","cotrimoxazole","2025-05-15",{"date":436,"type":42},"2025-05-20",{"date":438,"type":42},"2023-10-19",{"date":440,"type":21},"2026-12-31",{"name":416,"class":49},30,{"id":444,"slug":445,"hasResults":11,"nctId":446,"briefTitle":447,"officialTitle":448,"acronym":4,"eligibilityCriteria":449,"healthyVolunteers":11,"sex":17,"minAge":450,"maxAge":451,"enrollmentInfo":452,"targetDuration":4,"studyType":22,"phases":454,"briefSummary":455,"conditions":456,"keywords":4,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":459,"lastUpdatePostDateStruct":460,"startDateStruct":462,"completionDateStruct":464,"leadSponsor":466,"locationsCount":50},"100516149","frequent-standardized-oral-care-using-human-milk-in-the-neonatal-intensive-care-unit-100516149","NCT06000761","Frequent Standardized Oral Care Using Human Milk in the Neonatal Intensive Care Unit","Frequent Standardized Oral Care Using Human Milk to Prevent Oral Dysbiosis and Improve Health Outcomes in Premature Infants in the Neonatal Intensive Care Unit","Inclusion:\n\n* Mother ≥18 years of age\n* ≤ 30 weeks gestation\n* Born weighing ≤ 1500 grams\n\nExclusion:\n\n* Congenital anomalies of the face, lungs, or gastrointestinal system\n* Not expected to live \\> 7 days following delivery.","1 Hour","3 Days",{"count":453,"type":21},218,[156],"Premature infants are susceptible to complications related to infrequent and non-standardized oral care. Although the benefits of frequent standardized oral care are known to reduce oral dysbiosis (increased level of potentially pathogenic bacteria) and its associated complications in critically ill adults leading to established evidence-based guidelines, no such information exists for VLBW infants. The proposed study will prospectively follow 168 VLBW infants for 4 weeks following birth.",[32,457,458],"Bronchopulmonary Dysplasia","Respiratory Disease","2025-03-31",{"date":461,"type":42},"2025-04-01",{"date":463,"type":42},"2023-11-23",{"date":465,"type":21},"2026-12-20",{"name":467,"class":49},"University of Florida",{"id":469,"slug":470,"hasResults":11,"nctId":471,"briefTitle":472,"officialTitle":472,"acronym":473,"eligibilityCriteria":474,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":475,"targetDuration":4,"studyType":97,"phases":4,"briefSummary":477,"conditions":478,"keywords":4,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":482,"lastUpdatePostDateStruct":483,"startDateStruct":485,"completionDateStruct":487,"leadSponsor":488,"locationsCount":50},"100399707","lung-barometric-measurements-in-normal-and-in-respiratory-distressed-lungs-100399707","NCT04484727","\"Lung Barometric Measurements in Normal And in Respiratory Distressed Lungs\"","LUNAR","Inclusion Criteria:\n\n* Patients above18 years\n* ASA 1-3\n* Planned\u002Facute ventilator treatment in ICU or OR\n\nExclusion Criteria:\n\n* Patients under 18 years\n* ASA 4 and above\n* severe COPD\u002Femphysema\u002Fheart failure\n* PEEP\\>16 and\u002For FiO2 \\>80%\n* elevated intracranial pressure\n* defect coagulation\n* non-treated known or suspected pneumothorax",{"count":476,"type":21},200,"Little is known about how lung mechanics are affected during the very early phase after starting mechanical ventilation. Since the conventional method of measuring esophageal pressure is complicated, hard to interpret and expensive, there are no studies on lung mechanics on intensive care patients directly after intubation, during the first hours of ventilator treatment and forward until the ventilator treatment is withdrawn. Published studies have collected data using the standard methods from day 1 to 3 of ventilator treatment for respiratory system mechanics, i.e. the combined mechanics of lung and chest wall. Consequently, information on lung mechanical properties during the first critical hours of ventilator treatment is missing and individualization of ventilator care done on the basis of respiratory system mechanics, which are not representative of lung mechanics on an individual patient basis. We have developed a PEEP-step method based on a change of PEEP up and down in one or two steps, where the change in end-expiratory lung volume ΔEELV) is determined and lung compliance calculated as ΔEELV divided by ΔPEEP (CL = ΔEELV\u002FΔPEEP). This simple non-invasive method for separating lung and chest wall mechanics provides an opportunity to enhance the knowledge of lung compliance and the transpulmonary pressure. After the two-PEEP-step procedure, the PEEP level where transpulmonary driving pressure is lowest can be calculated for any chosen tidal volume.\n\nThe aim of the present study in the ICU is to survey lung mechanics from start of mechanical ventilation until extubation and to determine PEEP level with lowest (least injurious) transpulmonary driving pressure during ventilator treatment. The aim of the study during anesthesia in the OR, is to survey lung mechanics in lung healthy and identify patients with lung conditions before anesthesia, which may have an increased risk of postoperative complications.",[387,479,480,481,32],"Ventilatory Failure","Ventilator Lung","Ventilation Therapy; Complications","2025-03-13",{"date":484,"type":42},"2025-03-17",{"date":486,"type":42},"2022-05-01",{"date":440,"type":21},{"name":489,"class":49},"Göteborg University",{"id":491,"slug":492,"hasResults":11,"nctId":493,"briefTitle":494,"officialTitle":495,"acronym":496,"eligibilityCriteria":497,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":498,"targetDuration":4,"studyType":22,"phases":500,"briefSummary":501,"conditions":502,"keywords":503,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":506,"lastUpdatePostDateStruct":507,"startDateStruct":509,"completionDateStruct":511,"leadSponsor":513,"locationsCount":50},"100330371","phase-3-short-infusion-versus-prolonged-infusion-of-ceftolozane-tazobactam-among-patients-with-ventilator-associated-pneumonia-100330371","NCT03581370","Short Infusion Versus Prolonged Infusion of Ceftolozane-tazobactam Among Patients with Ventilator Associated-pneumonia","Comparison of Short Infusion Versus Prolonged Infusion of Ceftolozane-tazobactam Among Patients with Ventilator Associated-pneumonia to Pseudomonas Aeruginosa in Intensive Care Units","CEFTOREA","inclusion criteria\n\n* patients with ventilator associated-pneumonia to Pseudomonas aeruginosa\n* patients hospitalized in intensive care units\n* Pseudomonas aeruginosa susceptible to ceftolozane-tazobactam\n* Simplified Acute Physiological Score II (SAPS II () \\> 20\n* Expected duration of survival \\> 7 days\n* Informed consent of the patient or, failing that, the patient's close or trustworthy person\n* Affiliated to a social security scheme or equivalent\n\nNon inclusion criteria:\n\n* history of allergy to one of the two molecules\n* history of allergy to betalactamines\n* Strain Isolated resistant to Ceftolozane-Tazobactam combination\n* Renal insufficiency with a glomerular filtration rate evaluated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) \\\u003C 50 ml\u002Fmin\n* Patient on dialysis or under continuous hemodiafiltration\n* pregnant or nursing women\n* patient benefiting from a system of legal protection for adults\n* patient with active immunodepression.",{"count":499,"type":21},80,[62],"The main objective of this study is to compare the median exposures at pharmacokinetic equilibrium of the two modalities of administration: 4-hours infusion of ceftolozane-tazobactam at a dosage of 2 gram three times a day vs 1-hour infusion of 2 gram three times a day.",[100],[218,504,505],"Pseudomonas aeruginosa","pharmacokinetics","2024-09-23",{"date":508,"type":42},"2024-09-25",{"date":510,"type":42},"2018-09-20",{"date":512,"type":21},"2025-02",{"name":514,"class":49},"University Hospital, Toulouse",{"id":516,"slug":517,"hasResults":11,"nctId":518,"briefTitle":519,"officialTitle":520,"acronym":521,"eligibilityCriteria":522,"healthyVolunteers":11,"sex":17,"minAge":4,"maxAge":4,"enrollmentInfo":523,"targetDuration":4,"studyType":22,"phases":525,"briefSummary":526,"conditions":527,"keywords":531,"overallStatus":160,"whyStopped":4,"lastUpdateSubmitDate":542,"lastUpdatePostDateStruct":543,"startDateStruct":545,"completionDateStruct":547,"leadSponsor":548,"locationsCount":550},"100514518","phase-4-early-impact-therapy-with-ceftazidime-avibactam-via-rapid-diagnostics-100514518","NCT05979545","EaRly impAct theraPy With Ceftazidime-avibactam Via rapID Diagnostics","EaRly impAct theraPy With Ceftazidime-avibactam Via rapID Diagnostics Versus Standard of Care Antibiotics and Diagnostics in Patients With Bloodstream Infection, Hospital-acquired Pneumonia or Ventilator-associated Pneumonia Due to Pseudomonas Aeruginosa or Carbapenemase Producing Enterobacterales (RAPID)","RAPID","Inclusion Criteria:\n\n1. patient developed clinical symptoms compatible with bloodstream infection, hospital-acquired or ventilator-associated pneumonia (hospital-acquired and ventilator-associated pneumonia should fulfil US CDC NHSN criteria) AND,\n2. an appropriate specimen has been received by the participating laboratory - that is, a blood culture bottle showing Gram negative bacilli or a respiratory sample collected for clinical purposes showing Gram negative bacilli on Gram stain;\n\nExclusion Criteria:\n\n1. Refractory shock or comorbid condition such that patient not expected to survive more than 48 hours; OR,\n2. where the bloodstream infection is thought to be related to a vascular catheter and the catheter is unable to be removed; OR,\n3. treatment is not with the intent to cure the infection; OR,\n4. patient is incarcerated in a correctional facility; OR,\n5. patients previously randomised in this trial within the last 60 days.",{"count":524,"type":21},1900,[24],"The goal of this clinical trial is to propose a seamless intervention linking rapid bacterial isolate identification and antibiotic resistance gene detection and targeted antibiotic prescription to minimise time between infection onset and appropriate treatment in patients with Pseudomonas aeruginosa or carbapenemase producing Enterobacterales infections. This is an investigator initiated trial.\n\nThe primary hypothesis is that these interventions will lead to improved clinical outcomes amongst patients with hospital-acquired bloodstream infection, hospital-acquired pneumonia or ventilator-associated pneumonia due to carbapenem non-susceptible Pseudomonas aeruginosa or Enterobacterales, compared to standard antibiotic susceptibility testing.\n\nPatients will be randomised to either a control or intervention arm. Patients randomised to the intervention arm will have relevant specimens analysed by rapid microbiological diagnostics and will have early availability of ceftazidime-avibactam if appropriate. Patients randomised to the control arm, will have samples analysed by clinical microbiology laboratories using standard of care diagnostics. Antibiotics will be available to these patients as per usual institutional practice.",[528,32,529,530,246],"Blood Stream Infections","Healthcare Associated Infection","Carbapenem-Resistant Enterobacteriaceae Infection",[532,533,534,535,536,537,538,539,540,541],"rapid diagnostics","ceftazidime-avibactam","carbapenemase producing Enterobacterales","hospital-acquired","MDR","AMR","ASP","CRE","BCID2","PN Plus","2024-03-03",{"date":544,"type":42},"2024-03-06",{"date":546,"type":42},"2023-12-12",{"date":440,"type":21},{"name":549,"class":49},"National University of Singapore",4]