Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Autor Cavalcanti, Alexandre B. Google Scholar
Berwanger, Otavio Google Scholar
Suzumura, Erica A. Google Scholar
Amato, Marcelo B. P. Google Scholar
Tallo, Fernando S. Google Scholar
Rezende, Ederlon A. C. Google Scholar
Telles, Jose M. M. Google Scholar
Romano, Edson Google Scholar
Guimaraes, Helio P. Google Scholar
Regenga, Marisa M. Google Scholar
Takahashi, Luzia N. Google Scholar
Teixeira, Cassiano Google Scholar
Oliveira, Roselaine P. Google Scholar
Carvalho, Vitor O. Google Scholar
Diaz-Quijano, Fredi A. Google Scholar
Carvalho, Carlos R. R. Google Scholar
Kodama, Alessandra A. Google Scholar
Ribeiro, Gisele F. M. Google Scholar
Abreu, Matheus O. Google Scholar
Oliveira, Ivonaldo M. Google Scholar
Guyatt, Gordon Google Scholar
Ferguson, Niall Google Scholar
Walter, Stephen Google Scholar
Vasconcelos, Marcia O. M. Google Scholar
Segundo, Valerio J. Google Scholar
Ferraz, Iris L. Google Scholar
Silva, Rosicley S. Google Scholar
Oliveira Filho, Wilson de Google Scholar
Silva, Nelson B. Google Scholar
Heirel, Debora C. B. Google Scholar
Takatani, Rodrigo R. Google Scholar
Sousa Neto, Jefferson A. Google Scholar
Neto, Jeronimo C. B. Google Scholar
Almeida, Samara D. Google Scholar
Chamy, Gauco Google Scholar
Goncalves Neto, Graciliano J. L. Google Scholar
Dias, Alysson P. Google Scholar
Silva, Rozangela R. Google Scholar
Tavares, Roberta C. Google Scholar
Souza, Marcia L. V. D. Google Scholar
Decio, Janaina C. Google Scholar
Lima, Cyntia M. L. S. Google Scholar
Ferreira Neto, Fleury Google Scholar
Oliveira, Katia R. Google Scholar
Dias, Polyana P. L. C. Google Scholar
Brandao, Andre L. S. B. Google Scholar
Ramos, Joroastro E. Google Scholar
Vasconcelos, Paula T. Google Scholar
Flores, Dimitri G. Google Scholar
Pinheiro Filho, Gilvan R. Google Scholar
Andrade, Isaac G. Google Scholar
Martinez, Amadeu Google Scholar
Franca, Gustavo G. P. Google Scholar
Monteiro, Livia L. Google Scholar
Correia, Emmanuel I. S. Google Scholar
Ribeiro, Wagner Google Scholar
Pereira, Antonio J. Google Scholar
Andrade, Wandalvo Google Scholar
Leite, Petronio A. Google Scholar
Filgueira Feto, Jose E. Google Scholar
Holanda, Marcelo A. Google Scholar
Amorim, Fabio F. Google Scholar
Margalho, Silviano B. Google Scholar
Domingues, Sergio M. Google Scholar
Ferreira, Claiton S. Google Scholar
Ferreira, Cassia M. Google Scholar
Rabelo, Livia A. Google Scholar
Duarte, Juliana N. Google Scholar
Lima, Fernando B. Google Scholar
Kawaguchi, Ines A. L. Google Scholar
Araujo Neto, Jose A. Google Scholar
Maia, Marcelo O. Google Scholar
Correa, Fabiano G. Google Scholar
Ribeiro, Rubens A. B. Google Scholar
Caser, Eliana Google Scholar
Moreira, Cora L. C. B. Google Scholar
Marcilino, Antonielen Google Scholar
Falcao, Jansen G. Google Scholar
Jesus, Karinne R. Google Scholar
Tcherniakovisk, Leo Google Scholar
Dutra, Victor G. Google Scholar
Thompson, Marlus M. Google Scholar
Piras, Claudio Google Scholar
Giuberti, Jonas Google Scholar
Silva, Albano S. Google Scholar
Santos, Jose R. P. Google Scholar
Potratz, Jorge L. Google Scholar
Paula, Ludmila N. Google Scholar
Bozi, Giovana G. Google Scholar
Gomes, Bruno C. Google Scholar
Vassallo, Paula F. Google Scholar
Rocha, Edson P. Google Scholar
Lima, Maria H. B. S. Google Scholar
Ferreira, Denise M. Google Scholar
Goncalves, Fernanda A. F. Google Scholar
Pereira, Sheila A. Google Scholar
Nobrega, Marciano S. Google Scholar
Caixeta, Carlos R. Google Scholar
Moraes, Ana P. P. Google Scholar
Carvalho, Alexandre G. R. Google Scholar
Alves, Janine D. Google Scholar
Carvalho, Frederico B. Google Scholar
Moreira, Fabiana B. R. Google Scholar
Starling, Claudia M. Google Scholar
Couto, Wivian A. D. Google Scholar
Bitencourt, Wesley S. Google Scholar
Peixoto, Daniela C. Google Scholar
Carvalho, Ivana L. V. Google Scholar
Silva, Silvangela G. A. Google Scholar
Felizardo, Livia R. S. M. Google Scholar
Magalhaes Nascimento, Francine J. Google Scholar
Santos, Priscila J. C. D. Google Scholar
Zanta, Camila C. Google Scholar
Martins, Marcele F. Google Scholar
Naves, Sergio A. Google Scholar
Silva, Fabiano D. Google Scholar
Laube, Gilberto Google Scholar
Galvao, Endi L. Google Scholar
Sousa, Marcelo F. Google Scholar
Souza, Marcia M. F. Google Scholar
Carvalho, Fernanda L. G. Google Scholar
Bergo, Ricardo R. Google Scholar
Rezende, Claudnei M. Google Scholar
Tamazato, Edys Y. Google Scholar
Sarat, Saturnino Campo Google Scholar
Almeida, Patricia S. Google Scholar
Gorski, Anthony G. Google Scholar
Matsui, Mirna Google Scholar
Eberhart Neto, Ervin Google Scholar
Nomoto, Silmara H. Google Scholar
Lima, Zildamara B. Google Scholar
Inagaki, Alexandre S. Google Scholar
Gil, Fernando S. U. Google Scholar
Araujo, Mario F. A. Google Scholar
Oliveira, Aline E. Google Scholar
Correa, Tiago A. Google Scholar
Mendonca, Angela Google Scholar
Reis, Helder Google Scholar
Carneiro, Saul R. Google Scholar
Castanelo, Carlos Google Scholar
Coelho, Edward Google Scholar
Amaral, Karine A. E. H. Google Scholar
Rego, Leila R. M. Google Scholar
Cunha, Adenard F. C. Google Scholar
Barra, Williams F. Google Scholar
Carneiro, Mauricio Google Scholar
Batista, Roseane A. Google Scholar
Zoghbi, Karina K. Google Scholar
Machado, Nelma J. N. Google Scholar
Ferreira, Reinaldo Google Scholar
Apoena, Pablo Google Scholar
Leao, Rosangela M. Google Scholar
Martins, Eliauria R. Google Scholar
Oliveira, Marcelo E. Google Scholar
Odir, Isaura Google Scholar
Kleber, Wladimy Google Scholar
Tavares, Daniele Google Scholar
Araujo, Marcelo E. U. Google Scholar
Brilhante, Yuzeth Nobrega Google Scholar
Tavares, Daniele C. C. Google Scholar
Kleber, Wladmy Google Scholar
Carvalho, Waneska L. N. Google Scholar
Winveler, Georgia F. P. Google Scholar
Chagas Filho, Aldir Google Scholar
Cavalcanti, Raphael Ali Google Scholar
Grion, Cintia M. C. Google Scholar
Reis, Andrezza T. J. B. Google Scholar
Festti, Josiane Google Scholar
Gimenez, Francielli M. P. Google Scholar
Larangeira, Alexandre S. Google Scholar
Cardoso, Lucienne T. Q. Google Scholar
Mezzaroba, Ana L. Google Scholar
Giancursi, Thiago S. Google Scholar
Kauss, Ivanil A. M. Google Scholar
Duarte, Pericles A. D. Google Scholar
Tozo, Tatiane C. Google Scholar
Peliser, Priscila Google Scholar
Germano, Almir Google Scholar
Gurgel, Sanderland J. T. Google Scholar
Silva, Sandra R. B. Google Scholar
Kuroda, Cristina M. Google Scholar
Herek, Andrea Google Scholar
Yamada, Sergio S. Google Scholar
Schiavetto, Paulo M. Google Scholar
Wysocki, Natacha Google Scholar
Matsubara, Rosely R. Google Scholar
Sales, Joao A. L. Google Scholar
Laprovita, Maria P. Google Scholar
Pena, Felipe M. Google Scholar
Sa, Alexandre Google Scholar
Vianna, Arthur Google Scholar
Verdeal, Juan C. Google Scholar
Martins, Gloria A. Google Scholar
Salgado, Diamantino R. Google Scholar
Coelho, Adalberto M. Google Scholar
Coelho, Milena P. P. M. Google Scholar
Morong, Aline S. Google Scholar
Poquiriqui, Rodolfo M. B. Google Scholar
Ferreira, Ana P. Google Scholar
Lucena, Debora N. L. Google Scholar
Marino, Nathalia F. Google Scholar
Moreira, Monique A. Google Scholar
Uratani, Cristiana C. S. Google Scholar
Severino, Marta A. Google Scholar
Silva, Patricia N. Google Scholar
Medeiros, Luciana G. Google Scholar
Chaves Filho, Francisco G. Google Scholar
Guimaraes, Daniela M. Q. S. Google Scholar
Rezende, Valeria M. C. Google Scholar
Carbonell, Roberto C. C. Google Scholar
Trindade, Renata S. Google Scholar
Pellegrini, Jose A. S. Google Scholar
Boniatti, Marcio M. Google Scholar
Santos, Moreno C. Google Scholar
Boldo, Rodrigo Google Scholar
Oliveira, Vanessa M. Google Scholar
Correa, Viviane M. Google Scholar
Nedel, Wagner Google Scholar
Schaich, Felipe Google Scholar
Tagliari, Luciana Google Scholar
Savi, Augusto Google Scholar
Schulz, Luis F. Google Scholar
Maccari, Juara G. Google Scholar
Seeger, Gabriela M. Google Scholar
Foernges, Rafael B. Google Scholar
Rieder, Marcelo M. Google Scholar
Becker, Daniel A. Google Scholar
Broilo, Fabiano P. Google Scholar
Schwarz, Patricia Google Scholar
Alencastro, Andre Google Scholar
Berto, Paula Google Scholar
Backes, Fabiane Google Scholar
Dias, Fernando S. Google Scholar
Blattner, Clarissa Google Scholar
Martins, Edna T. J. Google Scholar
Scaglia, Nris C. Google Scholar
Vieira, Silvia R. R. Google Scholar
Prado, Karen F. Google Scholar
Fialkow, Lea Google Scholar
Franke, Cristiano Google Scholar
Vieira, Debora F. V. B. Google Scholar
Moraes, Rafael B. Google Scholar
Marques, Leonardo S. Google Scholar
Hopf, Joao L. S. Google Scholar
Wawrzeniak, Iuri C. Google Scholar
Rech, Tatiana H. Google Scholar
Albuquerque, Regis B. Google Scholar
Guerreiro, Marcio O. Google Scholar
Teixeira, Luciano O. Google Scholar
Macedo, Pedro L. Google Scholar
Bainy, Marina P. Google Scholar
Ferreira, Edgard V. Google Scholar
Martins, Marcio A. Google Scholar
Andrade, Luciana A. S. Google Scholar
Machado, Fernando O. Google Scholar
Burigo, Ana C. Google Scholar
Pincelli, Mariangela Google Scholar
Kretzer, Lara Google Scholar
Maia, Israel S. Google Scholar
Cordeiro, Rodrigo B. Google Scholar
Westphal, Glauco Google Scholar
Caldeira, Milton Google Scholar
Cramer, Amanda S. Google Scholar
Dadam, Michelli M. Google Scholar
Barbosa, Pierry O. Google Scholar
Brilenger, Caroline O. Google Scholar
Horner, Marina B. W. Google Scholar
Oliveira, Glauce L. Google Scholar
Germiniani, Bruno C. Google Scholar
Teixeira, Cristina Google Scholar
Duarte, Robson Google Scholar
Assef, Maria G. P. L. Google Scholar
Rosso, Deorgelis Google Scholar
Bigolin, Rodrigo Google Scholar
Vanzuita, Raquel Google Scholar
Prado, Luiz F. A. Google Scholar
Oliveira, Andre L. V. Google Scholar
Reis, Diego L. Google Scholar
Morais, Mirene O. Google Scholar
Bastos, Rafael S. Google Scholar
Santana, Hericalizandra S. R. Google Scholar
Silva, Alline O. Google Scholar
Cacau, Lucas A. P. Google Scholar
Almeida, Marilia S. Google Scholar
Canavessi, Hugo Schlebinger Google Scholar
Nogueira, Eduardo E. F. Google Scholar
Pavia, Caio L. P. Google Scholar
Araujo, Jose F. Google Scholar
Lira, Jose A. Google Scholar
Nienstedt, Esteban C. Google Scholar
Smith, Thiago C. Google Scholar
Romano, Marcelo Google Scholar
Barros, Dalton Google Scholar
Costa, Andre F. Google Scholar
Takahashi, Luzia Google Scholar
Werneck, Vinicius Google Scholar
Farran, Jorge Google Scholar
Henriques, Lilian A. Google Scholar
Miura, Claudia Google Scholar
Lopes, Renato D. Autor UNIFESP Google Scholar
Vendrame, Leticia S. Autor UNIFESP Google Scholar
Guimaraes, Helio P. Autor UNIFESP Google Scholar
Sandri, Priscila Autor UNIFESP Google Scholar
Galassi, Marcela S. Autor UNIFESP Google Scholar
Toufen, Carlos Google Scholar
Santiago, Roberta R. S. Google Scholar
Hirota, Adriana S. Google Scholar
Park, Marcelo Google Scholar
Azevedo, Luciano C. P. Google Scholar
Malbouison, Luiz M. Google Scholar
Costa, Maristela C. Google Scholar
Taniguchi, Leandro Google Scholar
Pompilio, Carlos E. Google Scholar
Baruzzi, Claudio Google Scholar
Andrade, Ana H. V. Google Scholar
Taira, Elisabete E. Google Scholar
Taino, Bruno Google Scholar
Oliveira, Clezio S. Google Scholar
Silva, Anselmo C. Google Scholar
Isola, Alexandre Google Scholar
Rezende, Ederlon Google Scholar
Rodrigues, Ricardo G. Google Scholar
Rangel, Vivian P. L. Google Scholar
Luzzi, Sergio Google Scholar
Giacomassi, Ivens W. S. Google Scholar
Nassar, Antonio P. Google Scholar
Souza, Ana R. Google Scholar
Rahal, Luciana Google Scholar
Nunes, Andre L. Google Scholar
Giannini, Fabio Google Scholar
Menescal, Brena Google Scholar
Morais, Jussara E. P. Google Scholar
Toledo, Diogo Google Scholar
Morsch, Rafaela D. Google Scholar
Merluzzi, Thalita Google Scholar
Amorim, Denise S. Google Scholar
Bastos, Ana C. A. G. Google Scholar
Santos, Patricia L. Google Scholar
Silva, Sabrina F. Google Scholar
Gallego, Raquel C. N. Google Scholar
Santos, Gheisa D. Google Scholar
Tucci, Mauro Google Scholar
Costa, Ramon T. Google Scholar
Santos, Lucio S. Google Scholar
Demarzo, Sergio E. Google Scholar
Schettino, Guilherme P. P. Google Scholar
Suzuki, Vivian C. Google Scholar
Patrocinio, Ana C. L. Google Scholar
Martins, Mariana L. Google Scholar
Passos, Denise B. V. G. Google Scholar
Cappi, Sylas B. Google Scholar
Goncalves, Iran Google Scholar
Borges, Marcos C. Google Scholar
Lovato, Wilson Google Scholar
Tavares, Marcel V. Google Scholar
Morales, Daniela Google Scholar
Machado, Luis A. M. W. Google Scholar
Torres, Franciele C. C. Google Scholar
Gomes, Tania M. Google Scholar
Cerantola, Rodrigo B. Google Scholar
Góis, Aécio Flávio Teixeira de Autor UNIFESP Google Scholar
Marraccini, Thiago Autor UNIFESP Google Scholar
Margarida, Kathia Autor UNIFESP Google Scholar
Cavalcante, Eulalia Autor UNIFESP Google Scholar
Machado, Flavia R. Autor UNIFESP Google Scholar
Mazza, Bruno F. Autor UNIFESP Google Scholar
Rossetti Santana, Heloisa B. Autor UNIFESP Google Scholar
Mendez, Vanessa M. F. Autor UNIFESP Google Scholar
Xavier, Patricia A. Autor UNIFESP Google Scholar
Rabelo, Melina V. Autor UNIFESP Google Scholar
Schievano, Fabiana R. Autor UNIFESP Google Scholar
Pinto, Walkyria A. M. Autor UNIFESP Google Scholar
Francisco, Renata S. Autor UNIFESP Google Scholar
Ferreira, Elaine M. Autor UNIFESP Google Scholar
Silva, Dafne C. B. Autor UNIFESP Google Scholar
Arduini, Rodrigo G. Autor UNIFESP Google Scholar
Aldrighi, Jose R. Google Scholar
Amaro, Andreson F. Google Scholar
Conde, Katia A. P. Google Scholar
Pereira, Cesar A. Google Scholar
Tarkieltaub, Elcio Google Scholar
Oliver, Wilson R. Google Scholar
Guadalupe, Erika G. L. Google Scholar
Acerbi, Paulo S. C. Google Scholar
Tomizuka, Carlos I. Google Scholar
Oliveira, Tatiana A. Google Scholar
Geha, Nadia N. Google Scholar
Mecatti, Giovana C. Google Scholar
Piovesan, Maysa Z. R. Google Scholar
Salomao, Maria C. Google Scholar
Moreno, Marcelo S. Google Scholar
Orsatti, Vinicius N. Google Scholar
Miranda, Whiniton Google Scholar
Ray, Alexandre Google Scholar
Guerra, Andre Google Scholar
Baptista Filho, Mario L. A. Google Scholar
Ferreira, Firmino H. Google Scholar
Viera Filho, Edesio Google Scholar
Canzi, Regina A. Google Scholar
Giuberti, Adriana F. T. Google Scholar
Garcez, Melissa C. M. Google Scholar
Pedro, A. Google Scholar
Sala, Andrea D. Google Scholar
Suguitani, Edmundo O. Google Scholar
Kazue, Priscila Google Scholar
Oliveira, Luiz R. C. Google Scholar
Infantini, Rodrigo M. Google Scholar
Carvalho, Fabricio R. T. Google Scholar
Andrade, Lucia C. Google Scholar
Santos, Thiago M. Google Scholar
Carmona, Cesar V. Google Scholar
Figueiredo, Luciana C. Google Scholar
Falcao, Antonio Google Scholar
Dragosavak, Desanka Google Scholar
Nogueira Filho, Wilson Google Scholar
Lunardi, Maria C. Google Scholar
Lago, Roberto Google Scholar
Gatti, Ciro Google Scholar
Chiasso, Tatiana M. Google Scholar
Santos, Grazielle O. Google Scholar
Silva, Aline C. F. Google Scholar
Araujo, Arthur C. Google Scholar
Ornellas, Izadora B. Google Scholar
Vieira, Vitor M. Google Scholar
Hajjar, Ludhmila A. Google Scholar
Figueiredo, Adelaide C. Google Scholar
Damasceno, Bruna Google Scholar
Pizarro, Camilo Google Scholar
Hinestrosa, Alfredo Google Scholar
Garcia L., Sandra M. C. Google Scholar
Gonzalez C., Octavio Google Scholar
Diaz S., Edgard Google Scholar
Raineri, Santi M. Google Scholar
Cortegiani, Andrea Google Scholar
ART Investigators Google Scholar
Writing Steering Comm Google Scholar
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Data Monitoring Comm Google Scholar
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Resumo Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART).Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. the intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. in the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). in both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. the primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle.Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.
Palavra-chave Acute respiratory distress syndrome
Alveolar recruitment
PEEP
Mechanical ventilation
Clinical trials
Randomized
Idioma Inglês
Financiador Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'
Brazilian Ministry of Health
Data de publicação 2012-08-28
Publicado em Trials. London: Biomed Central Ltd, v. 13, 14 p., 2012.
ISSN 1745-6215 (Sherpa/Romeo, fator de impacto)
Publicador Biomed Central Ltd
Extensão 14
Fonte http://dx.doi.org/10.1186/1745-6215-13-153
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000314100100001
Endereço permanente http://repositorio.unifesp.br/handle/11600/35182

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