COVID-19

4:1 ratio enteral ketogenic formula within 48 hours of intubation

Ketogenic diet

standard of care

Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12-March 16, 2020

Keto-diet for Intubated Critical Care COVID-19

Keto-diet for Intubated Critical Care COVID-19 (KICC-COVID19)

PaCO2 is the partial pressure of carbon dioxide Units: millimeters of mercury

Minute ventilation is the product of respiratory rate and tidal volume. Units: Liter per minute

Respiratory system compliance measures the extent to which the lungs will expand.
In a ventilated patient, compliance can be measured by dividing the delivered tidal volume by the [plateau pressure minus the total peep]. Units: liter/centimeter of water

Driving pressure is a measure of the strain applied to the respiratory system and the risk of ventilator-induced lung injuries Driving pressure = Plateau pressure - Total Positive end-expiratory pressure (PEEP) Units: centimeter of water

Ventilator synchrony is the match between the patient's neural inspiratory time and the ventilator insufflation time

Mean arterial pressure is the average pressure in a patient's arteries during one cardiac cycle. Mean arterial pressure = diastolic blood pressure +[1/3(systolic blood pressure - diastolic blood pressure)] Units: millimeter of mercury

FiO2: Fraction of Inspired Oxygen Percentage of oxygen in the air mixture that is delivered to the patient.
Units: %

PaO2/FiO2 ratio is the ratio of arterial oxygen partial pressure (PaO2) to fractional inspired oxygen.
Units: millimeter of mercury

pH measures hydrogen ion activity. It is a conventional part of every arterial blood gas determination pH: no units.

Bicarbonate is a conventional part of every arterial blood gas determination Units: milliequivalents/Liter

Red blood cell count measure anemia or hypoglycemia. Units: cells per liter

White blood cell count evaluates leukopenia or leukocytosis. Units: cells/liter

White cell differential shows the amount of neutrophils, lymphocytes, basophils, eosinophils and may give some clue of the type of infection. Units: %

Hemoglobin is an indirect way to measure red blood cells. Units: gram/deciliter

Hematocrit measures the volume percentage of red blood cells in blood. Units: %

Mean cell volume is a measure of the average volume of a red blood corpuscle. Units: femtoliters

Mean cell hemoglobin is the average mass of hemoglobin per red blood cell in a sample of blood. Units: picograms

Mean cell hemoglobin concentration is the average concentration of hemoglobin in a given volume of blood. Units: %

Platelet count measures the number of platelets in the blood and determines thrombocytopenia or thrombocytosis. Units: platelets/liter

Red cell distribution width is a measure of the range of variation of red blood cell volume. Units: no units

Liver function test Units: gram/deciliter

Liver function test Units: international units/liter

Liver function test Units: international units/liters

Kidney function test Units: milligram/deciliter

Kidney function test Units: millimole/liter

Kidney function test Units: gram/deciliter

If the patient needs mechanical ventilation for a second time, this information will be collected.

Time from intensive care unit admission until death or transfer to hospital bed.

Time from hospital admission to discharge from the hospital. This information will be collected.

Once the patient feels better and can leave the hospital, he/she will be discharged. The place of discharge (e.g. home, rehab facility, nursing home, etc), time and date will be collected.

Heart rate: is the number of times a person's heart beats per minute

Glucose: sugar in blood. Units: millimole/liter

Glucagon: hormone release by pancreas that increase concentration of glucose in blood. Units: nanogram/liter

Free fatty acids are fatty acids that are produced from triglycerides and are measure in blood.

Hormone that regulates glucose. Units: insulin units/liter

Leptin helps regulate and alter long-term food intake and energy expenditure. Units: nanogram/deciliter

C-reactive protein is a protein made by the liver that measures inflammation (e.g. pancreatitis). Units: microgram/milliliter

Cytokines are signaling molecules that measure inflammation.

Ferritin stores iron inside of cells. Units: nanogram/milliliter

Johns Hopkins University

This is a single-center, open-label, clinical trial designed to determine whether a ketogenic diet improves gas exchange and reduces ventilator requirements in patients with coronavirus disease intubated for respiratory failure. The study team will prospectively enroll 15 intubated patients with COVID-19 infection and administer a 4:1 ratio enteral ketogenic formula within 48 hours of intubation. This study will compare outcomes to a retrospective cohort of intubated patients with COVID-19 who did not receive ketogenic diet. As other clinical trials begin, co-administration of other therapies as well as standard care treatments will be recorded. In addition, the study will compare clinical outcomes with patients receiving exclusively standard clinical care.

Patients with moderate-to-severe Acute Respiratory Distress Syndrome treated solely with lung protective, low volume high positive end-expiratory pressure conventional mechanical ventilation (CMV) and recruitment maneuvers, as specified in detail in the Detailed Description section.

Patients with moderte-to-severe Acute Respiratory Distress Syndrome treated initially with a 96-hour-lasting session (session duration modifiable according to oxygenation criteria) of High-frequency oscillation (HFO)-Recruitment Maneuvers (RMs), and then with lung protective CMV interspersed to additional HFO-RMs sessions (if required according to study protocol). The protocolized use of HFO-RMs may extend until day 10 post-randomization, according to pre-specified oxygenation criteria. Full details are provided in the Detailed Description Section.

Acute Respiratory Distress Syndrome

Low tidal volume-high positive end-expiratory pressure conventional mechanical ventilation (CMV) and recruitment maneuvers, as specified in detail in the Detailed Description Section.

Lung protective CMV

Initial, 96-hour-lasting session (session duration modifiable according to oxygenation criteria) of High-frequency oscillation (HFO) combined with recruitment Maneuvers (RMs), followed by additional HFO-RMs sessions (if required according to the study protocol oxygenation criteria)during days 1-10. During the rest of the intervention period, patients will be treated with the same lung protective CMV strategy of the CMV arm. Additional details are provided in the Detailed Description Section.

HFO-RMs

Evaggelismos General Hospital

Larisa University General Hospital

High Frequency Oscillatory Ventilation for Acute Respiratory Distress Syndrome (ARDS)

Effect of Intermittent High Frequency Oscillatory Ventilation on the Pathophysiology and Survival of Patients With the Acute Respiratory Distress Syndrome.

Patient discharged home while not requiring any form of ventilatory assistance.

"60 minus days on ventilator until day 60 postrandomization"

"60 minus the days with an organ failure until day 60 postrandomization"

Ventilation-related (e.g. barotrauma); Recruitment Maneuver-related (e.g. hypotension or desaturation); Tracheal Gas Insufflation-related (e.g. tracheal mucosal damage)

Evolution of Physiological variables during the first 10 days post-randomization {comparison of gas-exchange, respiratory mechanics (14), hemodynamics, fluid balance of preceding 24 hours, and blood lactate; all between-group-compared variables to be concurrently determined within 8.30 to 9.00 a.m. of each one of the first 10 days post-randomization}

Determination of markers of inflammation (cytokines and Activin A) in bronchoalveolar lavage fluid and peripheral blood at baseline and on day 5 post-randomization. Additional determination of surfactant activity on the same time points.

Spyros D. Mentzelopoulos

Assistant Professor in Intensive Care Medicine

University of Athens

University of Thessaly

Patients will receive standard medical therapy for heart failure only and will not receive Autotitrating Positive Airway Pressure therapy.

Patients will receive Autotitrating Positive Airway Pressure therapy in addition to standard medical care for heart failure.

Patients will receive standard medical therapy for heart failure only and will not receive Autotitrating Positive Airway Pressure therapy.
0 participants analyzed. Study closed; PI no longer at the institution. Efforts to have the PI add the required information have been unsuccessful. No study data are available.

Control

Patients will receive Autotitrating Positive Airway Pressure therapy in addition to standard medical care for heart failure.
Autotitrating Positive Airway Pressure: Patients will be treated with Autotitrating Positive Airway Pressure therapy
0 participants analyzed. Study closed; PI no longer at the institution. Efforts to have the PI add the required information have been unsuccessful. No study data are available.

Autotitrating Positive Airway Pressure

Total

Sex: Female, Male

Region of Enrollment

0 participants analyzed. Study closed; PI no longer at the institution. Efforts to have the PI add the required information have been unsuccessful. No study data are available.

Reduction in Episodic Oxygen Desaturation

Readmission

Length of Stay

Visual Analog Scale of Shortness of Breath

Patients will receive standard medical therapy for heart failure only and will not receive Autotitrating Positive Airway Pressure therapy.
0 participants analyzed. The study was closed and the PI is not longer at the institution. The PI was contacted to complete requirements but the information was not added by the PI. No study data are available.

Patients will receive Autotitrating Positive Airway Pressure therapy in addition to standard medical care for heart failure.
Autotitrating Positive Airway Pressure: Patients will be treated with Autotitrating Positive Airway Pressure therapy
0 participants analyzed. The study was closed and the PI is not longer at the institution. The PI was contacted to complete requirements but the information was not added by the PI. No study data are available.

Overall Study

Roberta Costello; Research Compliance

Heart Failure

Sleep Apnea Syndromes

Patients will be treated with Autotitrating Positive Airway Pressure therapy

hypercapnia/nekróza

Keto-diet for Intubated Critical Care COVID-19

High Frequency Oscillatory Ventilation for Acute Respiratory Distress Syndrome (ARDS)

Treatment of Sleep Disordered Breathing In Acute Decompensated Heart Failure Patients

Nejúplnější databáze léčivých bylin podložená vědou