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COVIDPRoVENT-COVIDNCT04346342

PRactice of VENTilation in COVID-19 Patients (PRoVENT-COVID)

An observational study of COVID and Mechanical Ventilation, run by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) at 22 sites in Netherlands.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this national, multicenter service review is to determine and compare ventilation management in COVID-19 patients in the Netherlands, and to determine whether certain ventilation settings have an independent association with duration of ventilation. Read more about this study

Who is it for?
Ages 18 years and older
How many people
1,122 participants
Where
22 sitesNetherlands
Study dates
6 Mar 2020to 1 Sep 2020
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Invasively ventilated patients with COVID-19.

Who may be able to join

  • COVID-19, confirmed with polymerase chain reaction (PCR) and/or presence of typical abnormalities on chest computer tomography (CT)
  • Suspected COVID-19 infection, with no exclusion of diagnosis
  • Having received invasive ventilation

Who cannot join

  • Age <18 years
  • Already included in the same study in another hospital
  • Having had received invasive ventilation > 24 hours in a non-participating hospital

Trial locations and contacts

22 sites in 1 country.

22 sites in 1 country

Netherlands22 sites
  • Flevoziekenhuis

    Almere Stad

  • Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

    Amsterdam

  • Onze Lieve Vrouwe Gasthuis

    Amsterdam

  • Gelre ziekenhuizen

    Apeldoorn

  • Rijnstate Ziekenhuis

    Arnhem

  • Amphia Ziekenhuis

    Breda

  • Reinier de Graaf Gasthuis

    Delft

  • Ziekenhuis Gelderse Vallei

    Ede

  • Catharina Ziekenhuis

    Eindhoven

  • Maxima Medical Center

    Eindhoven

  • St Anna Ziekenhuis

    Geldrop

  • Universitair Medisch Centrum Groningen

    Groningen

  • Spaarne Gasthuis

    Haarlem

  • Dijklander Ziekenhuis

    Hoorn

  • Leeuwarden Medisch Centrum

    Leeuwarden

  • Maastricht Universitair Medisch Centrum

    Maastricht

  • St Antonius Ziekenhuis

    Nieuwegein

  • Maasstad Hospital

    Rotterdam

  • Zuyderland Medisch Centrum

    Sittard

  • Haaglanden Medisch Centrum

    The Hague

  • HagaZiekenhuis

    The Hague

  • Isala Ziekenhuis

    Zwolle

Other trials in Netherlands

About this study

Official title: PRactice of VENTilation in COVID-19 Patients (PRoVENT-COVID) - an Observational Study of Invasively Ventilated Patients in the Netherlands

The purpose of this national, multicenter service review is to determine and compare ventilation management in COVID-19 patients in the Netherlands, and to determine whether certain ventilation settings have an independent association with duration of ventilation.

In every adult invasively ventilated COVID-19 patient from a participating ICU, granular ventilator settings and parameters will be collected from start of invasive ventilation for up to 72 hours. Follow up is until ICU and hospital discharge, and until day 90. The primary outcome includes main ventilator settings (including tidal volume, airway pressures, oxygen fraction and respiratory rate). Secondary endpoints are ventilator-free days and alive at day 28 (VFD-28); duration of mechanical ventilation; use of prone positioning and recruitment maneuvers; duration of ICU and hospital stay; incidence of kidney injury; and ICU, hospital, 28-day and 90-day mortality.

Read the detailed description

Rationale:

The novel coronavirus disease (COVID-19) pandemic is rapidly expanding across the world, with over 60.000 new cases each day as of late March 2020. Healthcare workers are struggling to provide the best care for patients with proven or suspected COVID-19. Approaches for clinical care vary widely between and within countries and new insights are acquired rapidly. This includes the way invasive ventilation is applied.

Objective:

To determine and compare invasive ventilation settings and parameters in COVID-19 patients in the Netherlands, and to determine associations with clinical outcomes.

Hypotheses:

Invasive ventilation settings and parameters vary between intensive care units (ICUs) in hospitals in the Netherlands; certain ventilator settings have an independent association with duration of ventilation in COVID-19 patients.

Study design:

Multicenter, national, retrospective, observational study in COVID-19 patients with respiratory failure, requiring invasive ventilation in intensive care unit (ICU) in hospitals in the Netherlands.

Study population:

The data of at least 1,000 consecutively invasively ventilated COVID-19 patients admitted to intensive care units (ICUs) of hospitals in the Netherlands. This study will not be restricted to the 'formal' ICUs, as patients may also receive invasive ventilation in other locations within the hospital during the COVID-19 pandemic.

Methods:

In every patient, granular ventilator settings and parameters are collected from start of invasive ventilation for up to 72 hours. Patients will be followed up until ICU and hospital discharge, and until day 90.

Sample size calculation:

No formal sample size calculation is needed. We expect to capture at least 1,000 patients, but will continue collecting data of new patients for at least 8 weeks.

Study endpoints:

Main ventilator settings (including tidal volume, airway pressures, oxygen fraction and respiratory rate) (primary) and parameters (blood gas results); use of rescue therapies (including prone positioning); use of sedatives, vasopressors and inotropes; daily cumulative fluid balances; development of kidney injury; ventilator-free days and alive at day 28 (VFD-28), duration of ICU and hospital stay, and ICU, hospital and 90-day mortality.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness:

Retrospective collection of data regarding ventilation management and major clinical endpoints is without risk for the individual patient.

Keywords
COVID

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT04346342
Study groupRoleWhat they receive
Mechanical ventilationCOVID patients receiving invasive mechanical ventilation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ventilation Mode

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  2. Tidal volume set

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  3. Expiratory tidal volume

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  4. Positive end-expiratory pressure

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  5. Maximum airway pressure or plateau pressure (P plateau) or peak pressure (P peak) (cm H2O);

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  6. Level of pressure support above positive end-expiratory pressure (PEEP)

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  7. Inspired fraction of oxygen

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  8. Set and measured respiratory rate

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  9. Inspiration to expiration ratio

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

Secondary outcomes (11)
  1. Number of ventilation-free days and alive at day 28

    Measured: Until 28 days from initiation of mechanical ventilation

  2. Duration of ventilation in survivors;

    time between start invasive ventilation and successful extubation in survivors

    Measured: Until 28 days from initiation of mechanical ventilation

  3. Use of prone positioning

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  4. Use of recruitment maneuvers

    Measured: Day 1 to Day 3 from initiation of mechanical ventilation

  5. Incidence of acute kidney injury

    Measured: Until 28 days from initiation of mechanical ventilation

  6. Duration of ICU stay

    Time between admission and discharge ICU or death in ICU

    Measured: Until 28 days from initiation of mechanical ventilation

  7. Duration of hospital stay

    Time between admission and discharge from hospital or death in hospital

    Measured: Until 28 days from initiation of mechanical ventilation

  8. ICU mortality

    Any death during ICU stay

    Measured: Until 28 days from initiation of mechanical ventilation

  9. Hospital mortality

    Any death during hospital stay

    Measured: Until 28 days from initiation of mechanical ventilation

  10. 28-day mortality

    Measured: Until 28 days from initiation of mechanical ventilation

  11. 90-day mortality

    Measured: Until 90 days from initiation of mechanical ventilation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Apr 2020
  2. Study start6 Mar 2020
  3. Primary completion1 Sep 2020
  4. Study completion1 Sep 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Retrospective
Enrolment
1,122 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04346342
Sponsor's protocol ID
PRoVENT-COVID
Acronym
PRoVENT-COVID
Status last verified
Jul 2021
First submitted
9 Apr 2020
Last updated
6 Jul 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Ahuja S, de Grooth HJ, Paulus F, van der Ven FL, Serpa Neto A, Schultz MJ, Tuinman PR; PRoVENT-COVID Study Collaborative Group* 'PRactice of VENTilation in COVID-19'. Association between early cumulative fluid balance and successful liberation from invasive ventilation in COVID-19 ARDS patients - insights from the PRoVENT-COVID study: a national, multicenter, observational cohort analysis. Crit Care. 2022 Jun 1;26(1):157. doi: 10.1186/s13054-022-04023-y.

    PubMed 35650616
  • Schuijt MTU, van Meenen DMP, Martin-Loeches I, Mazzinari G, Schultz MJ, Paulus F, Serpa Neto A. Association of Time-Varying Intensity of Ventilation With Mortality in Patients With COVID-19 ARDS: Secondary Analysis of the PRoVENT-COVID Study. Front Med (Lausanne). 2021 Nov 18;8:725265. doi: 10.3389/fmed.2021.725265. eCollection 2021.

    PubMed 34869421
  • Bos LDJ, Sjoding M, Sinha P, Bhavani SV, Lyons PG, Bewley AF, Botta M, Tsonas AM, Serpa Neto A, Schultz MJ, Dickson RP, Paulus F; PRoVENT-COVID collaborative group. Longitudinal respiratory subphenotypes in patients with COVID-19-related acute respiratory distress syndrome: results from three observational cohorts. Lancet Respir Med. 2021 Dec;9(12):1377-1386. doi: 10.1016/S2213-2600(21)00365-9. Epub 2021 Oct 13.

    PubMed 34653374
  • Schuijt MTU, Schultz MJ, Paulus F, Serpa Neto A; PRoVENT-COVID Collaborative Group. Association of intensity of ventilation with 28-day mortality in COVID-19 patients with acute respiratory failure: insights from the PRoVENT-COVID study. Crit Care. 2021 Aug 6;25(1):283. doi: 10.1186/s13054-021-03710-6.

    PubMed 34362415
  • Valk CMA, Tsonas AM, Botta M, Bos LDJ, Pillay J, Serpa Neto A, Schultz MJ, Paulus F; Writing Committee for the PRoVENT-COVID * Collaborative Group. Association of early positive end-expiratory pressure settings with ventilator-free days in patients with coronavirus disease 2019 acute respiratory distress syndrome: A secondary analysis of the Practice of VENTilation in COVID-19 study. Eur J Anaesthesiol. 2021 Dec 1;38(12):1274-1283. doi: 10.1097/EJA.0000000000001565.

    PubMed 34238782
  • Boers NS, Botta M, Tsonas AM, Algera AG, Pillay J, Dongelmans DA, Horn J, Vlaar APJ, Hollmann MW, Bos LDJ, Paulus F, Neto AS, Schultz MJ; PRoVENT-COVID investigatorsdagger. PRactice of VENTilation in Patients with Novel Coronavirus Disease (PRoVENT-COVID): rationale and protocol for a national multicenter observational study in The Netherlands. Ann Transl Med. 2020 Oct;8(19):1251. doi: 10.21037/atm-20-5107.

    PubMed 33178783
  • Botta M, Tsonas AM, Pillay J, Boers LS, Algera AG, Bos LDJ, Dongelmans DA, Hollmann MW, Horn J, Vlaar APJ, Schultz MJ, Neto AS, Paulus F; PRoVENT-COVID Collaborative Group. Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): a national, multicentre, observational cohort study. Lancet Respir Med. 2021 Feb;9(2):139-148. doi: 10.1016/S2213-2600(20)30459-8. Epub 2020 Oct 23.

    PubMed 33169671

Questions about this trial

What is this clinical trial studying?

An observational study of COVID and Mechanical Ventilation, run by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) at 22 sites in Netherlands.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 22 sites in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ventilation Mode (time frame: Day 1 to Day 3 from initiation of mechanical ventilation). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04346342, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Jul 2021.

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