Reverse Trigger Phenotypification and Response to Ventilatory Adjustments

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Conditions studied: Reverse Trigger, Acute Respiratory Distress Syndrome, Mechanical Ventilation

In brief

The goal of this prospective observational study is to describe the incidence of reverse trigger (RT) in mechanically ventilated patients with diagnosis of acute respiratory distress syndrome (ARDS). The main questions it aims to answer are: * Real incidence of RT based on continuous monitoring * The response to mechanical ventilatiory adjustments Participants will be included as soon as neuromuscular blockers (NMB)/sedation is stopped or in case of spontaneous respiratory efforts detection, whatever happens first. Continuous monitoring will be performed by esophageal manometry until switch to a pressure support (spontaneous) mode, restart of deep sedation/neuromuscular blockers by medical indication, or death. In order to allow detection of possible RT in patients with ongoing sedation/NMB, mechanical ventilator waveforms will be screened every 1-2 hours by investigators and critical care physicians with at least 1 year of specific training in detection of dyssynchronies.

Key facts

Study ID

NCT06148467

Run by

Hospital Civil de Guadalajara

People needed

130

Starts

2023-11-17

Expected to finish

2026-02-01

Last updated by the study team

2025-03-18

Who can join

Age: 18 and older, up to 90. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Diagnosis of ARDS according to the Berlin criteria and added New Global Definition 2023
• Mechanical ventilation

You may not qualify if…

• <18 years
• Tracheostomy status
• Pneumothorax
• Tube thoracostomy with air leaks

Where it is running

• Hospital Civil Fray Antonio Alcalde — Guadalajara, Mexico (enrolling)

Full record on ClinicalTrials.gov

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