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Inhaled AP301 for treatment of pulmonary edema in mechanically ventilated patients with acute respiratory distress syndrome: a phase IIa randomized placebo-controlled trial
- Source :
- Critical Care, Critical Care, Vol 21, Iss 1, Pp 1-11 (2017)
- Publication Year :
- 2017
-
Abstract
- Background High-permeability pulmonary edema is a hallmark of acute respiratory distress syndrome (ARDS) and is frequently accompanied by impaired alveolar fluid clearance (AFC). AP301 enhances AFC by activating epithelial sodium channels (ENaCs) on alveolar epithelial cells, and we investigated its effect on extravascular lung water index (EVLWI) in mechanically ventilated patients with ARDS. Methods Forty adult mechanically ventilated patients with ARDS were included in a randomized, double-blind, placebo-controlled trial for proof of concept. Patients were treated with inhaled AP301 (n = 20) or placebo (0.9% NaCl; n = 20) twice daily for 7 days. EVLWI was measured by thermodilution (PiCCO®), and treatment groups were compared using the nonparametric Mann–Whitney U test. Results AP301 inhalation was well tolerated. No differences in mean baseline-adjusted change in EVLWI from screening to day 7 were found between the AP301 and placebo group (p = 0.196). There was no difference in the PaO2/FiO2 ratio, ventilation pressures, Murray lung injury score, or 28-day mortality between the treatment groups. An exploratory subgroup analysis according to severity of illness showed reductions in EVLWI (p = 0.04) and ventilation pressures (p
- Subjects :
- 0301 basic medicine
Adult
Male
ARDS
Organ Dysfunction Scores
ENaC
Placebo-controlled study
Pulmonary Edema
Lung injury
Critical Care and Intensive Care Medicine
Placebo
Peptides, Cyclic
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
Administration, Inhalation
Medicine
Humans
ddc:610
Diffuse alveolar damage
Lung
Aged
Respiratory Distress Syndrome
Acute respiratory distress syndrome
business.industry
Research
lcsh:Medical emergencies. Critical care. Intensive care. First aid
lcsh:RC86-88.9
Middle Aged
Pulmonary edema
medicine.disease
Respiration, Artificial
Clinical trial
030104 developmental biology
medicine.anatomical_structure
030228 respiratory system
Anesthesia
Breathing
Female
Alveolar fluid clearance
business
Subjects
Details
- ISSN :
- 1466609X
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Critical care (London, England)
- Accession number :
- edsair.doi.dedup.....3b4dc185fbadc42db0f8d80e80f91129