NCT04009330

Brief Summary

Patients prospectively classified to the hyper-inflammatory ARDS phenotype on the basis of clinical characteristics and a novel POC biomarker assay will have worse clinical outcomes than the hypo-inflammatory phenotype. Study Aim The purpose of this project is to prospectively identify hyper- and hypo-inflammatory phenotypes in patients with ARDS and determine clinical outcomes associated with each phenotype. The primary objective of this study is to assess the clinical outcomes in patients with ARDS according to their prospectively defined inflammatory phenotype determined using a POC assay. Results of group allocation will be blinded to clinical and research staff until database lock. Secondary Objectives The secondary objectives of this study are to: (i) Assess the agreement of the phenotype allocation using the POC assay and the clinical study dataset. (ii) Assess the stability of phenotype allocation over time (iii) To test feasibility of delivering a POC assay in the NHS intensive care setting.

Trial Health

58
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
480

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Nov 2019

Longer than P75 for all trials

Geographic Reach
2 countries

22 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 15, 2019

Completed
2 months until next milestone

First Posted

Study publicly available on registry

July 5, 2019

Completed
5 months until next milestone

Study Start

First participant enrolled

November 22, 2019

Completed
4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 27, 2023

Completed
2.3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

February 27, 2026

Completed
Last Updated

July 25, 2025

Status Verified

July 1, 2025

Enrollment Period

4 years

First QC Date

May 15, 2019

Last Update Submit

July 22, 2025

Conditions

Keywords

hyper and hypo-inflammatoryPhenotypesPOC (point of care)

Outcome Measures

Primary Outcomes (1)

  • The primary outcome is mortality at 60 days in the hyper-inflammatory and hypo-inflammatory phenotypes in patients with ARDS.

    The primary outcome is mortality at 60 days in the hyper-inflammatory and hypo-inflammatory phenotypes in patients with ARDS.

    60 days

Secondary Outcomes (12)

  • Difference in time to extubation

    60 days

  • Intubation rate in patients on HFNO

    60 days

  • Reintubation Rate

    60 days

  • Number of ventilator free days at day 28

    28 days

  • Number of days on ventilation

    60 days

  • +7 more secondary outcomes

Study Arms (1)

Adults in the Intensive Care Setting

Adults in the Intensive Care Setting

Diagnostic Test: POC Assay

Interventions

POC AssayDIAGNOSTIC_TEST

Interventions: Blood Baseline - up to 40ml Day 3 - up to 40ml Urine Baseline - 10ml Day 3 - 10ml Study population: Adults (18 plus) in ICU units diagnosed with ARDS.

Adults in the Intensive Care Setting

Eligibility Criteria

Age18 Years+
Sexall
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Patients with ARDS in the ICU.

You may qualify if:

  • Patient is receiving mechanical ventilation or high flow nasal oxygen (HFNO)
  • ARDS as defined by the Berlin definition (Ranieri et al.) a) Onset within 1 week of identified insult b) Within the same 24-hour time period: i. Hypoxic respiratory failure (PaO2/ FiO2 ratio ≤ 40kPa on PEEP ≥ 5 cmH20\*) ii. Bilateral infiltrates consistent with pulmonary oedema not explained by another pulmonary pathology iii. Respiratory failure not fully explained by cardiac failure or fluid overload
  • The time of onset of ARDS is when the last ARDS criterion is met.
  • \*PEEP assumed ≥ 5 cmH20 if on HFNO.

You may not qualify if:

  • Age \<18 years of age
  • More than 48 hrs after onset of ARDS
  • Receiving ECMO at the time of recruitment
  • Treatment withdrawal imminent within 24 hours
  • DNAR (Do Not Attempt Resuscitation) order (excluding advance directives) in place
  • Declined consent
  • Prisoners

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (22)

St Vincents Hospital

Dublin, Ireland, D04 T6F4, Ireland

Location

University Hospital Birmingham

Birmingham, England, B15 2TH, United Kingdom

Location

Royal Blackburn Hospital

Blackburn, England, BB2 3HH, United Kingdom

Location

Royal Liverpool University Hospital

Liverpool, England, L7 8XP, United Kingdom

Location

University College London

London, England, NW1 2BU, United Kingdom

Location

Guys and St Thomas Hospital

London, England, SE1 7EH, United Kingdom

Location

Kings College Hospital

London, England, SE5 9RS, United Kingdom

Location

Wythenshawe Hospital

Manchester, England, M23 9QZ, United Kingdom

Location

Manchester Royal Infirmary

Manchester, England, United Kingdom

Location

Freemans Hospital

Newcastle upon Tyne, England, United Kingdom

Location

Nottingham University Hospital

Nottingham, England, NG7 2UH, United Kingdom

Location

Royal Berkshire Hospital

Reading, England, RG1 5AN, United Kingdom

Location

Sunderland Royal

Sunderland, England, SR4 7TP, United Kingdom

Location

Royal Cornwall Hospital

Truro, England, TR1 3LI, United Kingdom

Location

Edinburgh Royal Infirmary

Edinburgh, Scotland, EH16 4SB, United Kingdom

Location

Glasgow Royal Infirmary

Glasgow, Scotland, G31 2ER, United Kingdom

Location

University Hospital of Wales

Cardiff, Wales, CF14 4XW, United Kingdom

Location

Royal Gwent Hospital

Newport, Wales, NP18 3XQ, United Kingdom

Location

Royal Victoria Hospital

Belfast, United Kingdom

Location

Birmingham Heartlands Hospital

Birmingham, B9 5SS, United Kingdom

Location

Imperial College London

London, United Kingdom

Location

Oxford University Hospitals

Oxford, United Kingdom

Location

Related Publications (1)

  • ARDS Definition Task Force; Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012 Jun 20;307(23):2526-33. doi: 10.1001/jama.2012.5669.

    PMID: 22797452BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

Samples to be retained are: Li heparin plasma, Na3citrate plasma, Serum, Pax-Gene DNA, PBMC, Pax-Gene RNA and Urine

MeSH Terms

Conditions

Respiratory Distress Syndrome

Condition Hierarchy (Ancestors)

Lung DiseasesRespiratory Tract DiseasesRespiration Disorders

Study Officials

  • Professor D McAuley

    Queens University Belfast

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

May 15, 2019

First Posted

July 5, 2019

Study Start

November 22, 2019

Primary Completion

November 27, 2023

Study Completion

February 27, 2026

Last Updated

July 25, 2025

Record last verified: 2025-07

Data Sharing

IPD Sharing
Will share

Following the publication of the primary and secondary outcomes there may be scope to conduct additional analyses on the data collected. In such instances formal requests for data will need to be made in writing to the CI via the Northern Ireland Clinical Trials Unit, who will discuss this with the sponsor.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR
Time Frame
Following the publication of the primary and secondary outcomes.
Access Criteria
Formal requests for data will need to be made in writing to the CI via the Northern Ireland Clinical Trials Unit, who will discuss this with the sponsor.
More information

Locations