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The following is a summary of the research projects related to mechanical ventilation that are currently ongoing at St. Micheal's Hospital and University Health Network.

Abs-MV

Abdominal Muscle Thickness in Mechanically Ventilated Patients During Spontaneous Breathing Trials

Purpose/Aim/Goal

To determine to what extent the abdominal muscles contribute to airway pressure, in order to investigate the correlation between abdominal muscles weakness and extubation in mechanically ventilated patients.

Clincaltrials.gov Identifier: NCT03567564

Hospital: UHN


ALIVE

Assessing Lung Inhomogeneity During Ventilation for Acute Hypoxemic Respiratory Failure

Purpose/Aim/Goal

To determine the effect of PEEP on mechanisms of ventilator-induced lung injury in patients with ARDS and to evaluate various techniques for determining the most effective level of PEEP to avoid such injury.

Clinicaltrials.gov Identifier: NCT03108118

Hospital: UHN


BEARDS

Incidence of dyssynchronous spontaneous Breathing Effort, breath-stacking and reverse triggering in early ARDS

Purpose/Aim/Goal

To assess the incidence, physiological and clinical consequences of spontaneous breathing effort, dyssynchrony and reverse triggering at the early phase of ARDS in continuously sedated patients during controlled ventilation and at the time of transition to partial ventilatory support.

This is a multi-center trial with 34 centers.

ClinicalTrials.gov Identifier: NCT03447288

Hospital: SMH


DIASPORA

Diaphragm Structure and Pathobiology in Patients Being Bridged to Lung Transplant

Purpose/Aim/Goal

To determine whether different forms of respiratory support (MV vs. ECLS) lead to different degrees of diaphragm injury during bridging to lung transplant, and to characterize changes in diaphragm structure, function and biology through ultrasound, histological examination, and electron microscopy.

Clinicaltrials.gov Identifier: NCT03667027

Hospital: UHN


FAST-NWC

Frequency of Screening And SBT Technique Trial 

Purpose/Aim/Goal

  1. To identify the best strategy for clinicians to use to liberate critically ill adults from ventilators to improve the health outcomes of critically ill adults.
  2. To inform clinical decision-making and enhance care delivery.
  3. To build a structural framework for future trials through novel collaborations

ClinicalTrials.gov Identifier: NCT02969226

Hospital: SMH


FLOWLY

Screening expiratory flow limitation by flow-time curve

Purpose/Aim/Goal

To test the hypothesis that parameters derived from the flow-time curve can accurately detect the EFL in real time during mechanical ventilation.

General Inclusion: Any patient intubated and able to  ventilated in MISCU

ClinicalTrials.gov Identifier: NCT03215316

Hospital: SMH


HiFOLD

High Flow Nasal Cannula versus Non-Invasive Ventilation in exacerbations of Chronic Obstructive Pulmonary disease

Purpose/Aim/Goal

To compare the physiological effect of NIV and HFNC in COPD patients requiring intermittent NIV treatment.

ClinicalTrials.gov Identifier: NCT03033251

Hospital: SMH


LANDMARK

Lung and Diaphragm-Protective Ventilation by Means of Assessing Respiratory Work

Purpose/Aim/Goal

To test an innovative new lung- and diaphragm-protective ventilation strategy by titrating ventilator support and sedation to achieve safe levels of lung stress and inspiratory effort in patients with acute hypoxemic respiratory failure.

Clinicaltrials.gov Identifier: NCT03612583

Hospital: UHN


MYOTRAUMA

Diaphragm Injury and Dysfunction During Mechanical Ventilation

Purpose/Aim/Goal

To ascertain the relationship between diaphragm inactivity, patient-ventilator dyssynchrony and changes in diaphragm structure and function over the early course of mechanical ventilation, as well as describe the degree of diaphragm activity in different mechanically ventilated patient populations.

Clinicaltrials.gov Identifier: NCT03108118

Hospital: UHN


OWED

Prediction of Outcome of Weaning from mechanical ventilation using the Electrical activity of the Diaphragm

Purpose/Aim/Goal

To test whether changes in VT after the removal of a standardized level of NAVA assistance can predict weaning outcome.

ClinicalTrials.gov Identifier: NCT02539732


PROMIZING

Proportional Assist Ventilation for Minimizing the Duration of Mechanical Ventilation

Purpose/Aim/Goal

To determine whether PAV+ reduces time on the ventilator compared to pressure support when used as the standard supportive mode.

ClinicalTrials.gov Identifier: NCT02447692


USEFUL

Ultrasound to Evaluate Failure of Liberation from Mechanical Ventilation

Purpose/Aim/Goal

  1. To establish the utility of a rapid cardiothoracic ultrasound examination to diagnose physiological mechanisms of ventilator liberation failure.
  2. To assess the relationship between cardiothoracic variability during spontaneous breathing and different physiological mechanisms of weaning failure

ClinicalTrials.gov Identifier: NCT02723565

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