New study tests better breathing support for critically ill patients

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age between 18-60 years old. * Sex: both males and females * Accepts health volunteers: No * all Patients who were mechanically ventilated and diagnosed to have ARDS due to sepsis according to Berlin definition. During the course of the study, a new global definition for ARDS was introduced. To ensure our findings align with the most updated classification, we modified our inclusion criteria to incorporate the new global definition. Patients meeting the Berlin Definition or the new definition were included. Berlin Definition of the acute respiratory distress syndrome (ARDS) Acute Respiratory Distress Syndrome Timing Within 1 week of a known clinical insult or new or worsening respiratory Symptoms Chest imaging Bilateral opacities - not fully explained by effusion, lobar/lung collapse, or nodules. Origin of edema Respiratory failure not fully explained by cardiac failure or fluid overload need objective assessment (eg, echocardiography) to exclude hydrostatic edema if no risk factor present. Oxygenation Mild 200 mmHg \<Pao2/Fio2 \< 300 mmHg with PEEP or CPAP \> 5 cmH2O. Moderate 100 mmHg \<Pao2/Fio2 \< 200 mmHg with PEEP \> 5 cmH2O. Severe Pao2/Fio2 \< 100 mmHg with PEEP \> 5 cmH2O. (Gordon D, et al; 2012). Diagnostic Criteria for the New Global Definition of ARDS Acute Respiratory Distress Syndrome Risk factors and origin of edema Precipitated by an acute predisposing risk factor, such as pneumonia, non-pulmonary infection, trauma, transfusion, aspiration, or shock. Pulmonary edema is not exclusively or primarily attributable to cardiogenic pulmonary edema/fluid overload, and hypoxemia/gas exchange abnormalities are not primarily attributable to atelectasis. However, ARDS can be diagnosed in the presence of these conditions if a predisposing risk factor for ARDS is also present. Timing Acute onset or worsening of hypoxemic respiratory failure within 1 week of the estimated onset of the predisposing risk factor or new or worsening respiratory symptoms. Chest imaging Bilateral opacities on chest radiography and computed tomography or bilateral B lines and/or consolidations on ultrasound\* not fully explained by effusions, atelectasis, or nodules / masses. Oxygenation Non-intubated ARDS Intubated ARDS Modified Definition for Resource-Limited Settings * PaO2:FIO2\<300mmHg or * SpO2:FIO2\<315 (if SpO2\<97%) on HFNO with flow of \>30 L/min or NIV/CPAP with at least 5 cm H2O end-expiratory pressure Mild: * 200\<PaO2:FIO2\<300 mm Hg Or * 235\<SpO2:FIO2\<315 (if SpO2\<97%) Moderate: * 100, PaO2:FIO2\<200 mm Hg or * 148\<SpO2:FIO2\<235 (if SpO2\<97%) Severe: * PaO2:FIO2\<100 mm Hg or * SpO2:FIO2\<148 (if SpO2\<97%) • SpO2:FIO2\<315 (if SpO2\<97%). * Neither positive end-expiratory pressure nor a minimum flow rate of oxygen is required for diagnosis in resource-limited settings. (Matthay MA, et al; 2024). Exclusion Criteria: * Patient refusal * Patient with advanced cardiac disorders (rheumatic or ischemic). * Patients with COPD, pneumothorax, surgical emphysema. * Patients with advanced liver or renal disorders * Patients with advanced malignancy. * Female patients during pregnancy.