75 Participants NeededMy employer runs this trial

Ventilation Modes for Respiratory Failure in Cardiovascular Disease

Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Mayo Clinic
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

Cardiac disease complicated by respiratory insufficiency comprises the most frequent indication for cardiac intensive care unit (CICU) admission, with nearly one-third patients requiring advanced respiratory support and over 20% patients requiring invasive mechanical ventilation (IMV). IMV among patients with impaired cardiovascular reserve is further compounded by the adverse impact of positive pressure ventilation (PPV) and systemic sedation on intracardiac hemodynamics, pulmonary vascular mechanics and consequently end-organ perfusion. Despite widespread use, evidence guiding optimal ventilatory practices and mode selection in cardiovascular intensive care unit patients remains limited. Pressure-controlled and volume-controlled ventilation may differ in their effects on patient-ventilator synchrony, sedation requirements, and hemodynamic impact, but comparative data among patients with critical cardiac disease remains inconclusive. This pilot study will evaluate the feasibility of implementing a pragmatic cluster-randomized crossover trial comparing ventilatory modes in a contemporary cardiovascular intensive care unit.

Are You a Good Fit for This Trial?

This trial is for adults (18+) in the cardiac ICU who need a breathing machine (ventilator) for more than 12 hours due to serious heart and lung problems, such as cardiogenic shock or severe heart failure. People with certain lung diseases, short-term ventilation needs, home ventilators, pregnancy, incarceration, or on ECMO can't join.

Inclusion Criteria

Pre-Specified Subgroup: Mechanical circulatory support use, including intra-aortic balloon pumps and microaxial flow pumps such as Impella CP, RP Impella Flex, and Impella 5.5 devices
I have heart failure with an ejection fraction below 40%.
I have moderate to severe right heart pumping problems.
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Exclusion Criteria

Expected duration of intubation <12 hours
I have severe lung disease or breathing problems.
Home ventilator or chronic tracheostomy
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

Treatment

Participants receive either pressure-controlled or volume-controlled ventilation in the cardiac ICU

48 hours
Continuous monitoring in ICU

Follow-up

Participants are monitored for safety and effectiveness after treatment, including in-hospital mortality and ventilator-free days

28 days

What Are the Treatments Tested in This Trial?

Trial Overview

The study compares two common ways of using a ventilator—volume-controlled mode versus pressure-controlled mode—in critically ill heart patients. Patients are assigned by groups to each method to see which works better and is easier to use in real-world settings.

How Is the Trial Designed?

2

Treatment groups

Active Control

Group I: Pressure Controlled VentilationActive Control1 Intervention
Group II: Volume-Controlled VentilationActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials
3,427
Recruited
3,221,000+