Evidence map›Paper›PMID 41730551›Full record

Trial reportBMJ open2026

Careful ventilation in acute respiratory distress syndrome: the protocol of the CAVIARDS international multicentre randomised basket trial.

Rémi Coudroy, Irene Telias, Annemijn Jonkman, Arnaud W Thille, Jean-Luc Diehl, Nicolas Péron, Matthew Ko, Anne-Astrid Bourion, Norberto Tiribelli, Sebastián Fredes and 51 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03963622 (Careful Ventilation in Acute Respiratory Distress Syndrome), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03963622 narecruitingnot on this map

Careful Ventilation in Acute Respiratory Distress Syndrome

TypeinterventionalSponsorUnity Health TorontoRan2020 to 2026Enrolled740ConditionsARDSArmsRespiratory Mechanics, Standard Ventilation Strategy
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

61 authors.

Rémi CoudroyMédecine Intensive et Réanimation, CHU Poitiers, Poitiers, France r.coudroy@yahoo.fr.ORCID http://orcid.org/0000-0002-0036-1899
Irene TeliasInterdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Annemijn JonkmanIntensive Care Volwassenen, Erasmus MC, Rotterdam, Netherlands.
Arnaud W ThilleMédecine Intensive et Réanimation, CHU Poitiers, Poitiers, France.ORCID http://orcid.org/0000-0002-7798-6715
Jean-Luc DiehlService de Médecine Intensive Réanimation, Hôpital Européen Georges Pompidou, Paris, France.
Nicolas PéronService de Médecine Intensive Réanimation, Hôpital Européen Georges Pompidou, Paris, France.
Matthew KoSt Michael's Hospital Keenan Research Centre for Biomedical Science, Toronto, Ontario, Canada.
Anne-Astrid BourionEquipe d'Anesthésie Réanimation, Cholet Hospital Center, Cholet, France.
Norberto TiribelliServicio de Kinesiología, Unidad de Medicina Crítica y Terapia Intensiva, Complejo Médico de la Policia Federal Argentina Churruca Visca, Buenos Aires, Argentina.
Sebastián FredesServicio de Kinesiología, Unidad de Medicina Crítica y Terapia Intensiva, Complejo Médico de la Policia Federal Argentina Churruca Visca, Buenos Aires, Argentina.
Magalí GutiérrezUnidad de Cuidados Especiales, Sanatorio Mater Dei, Buenos Aires, Argentina.
Augustín Manchado BrunoUnidad de Cuidados Especiales, Sanatorio Mater Dei, Buenos Aires, Argentina.
Daniela N VasquezUnidad de Cuidados Intensivos, Sanatorio Anchorena, Buenos Aires, Argentina.
Romina A PrattoServicio de Kinesiología y Rehabilitación, Unidad de Cuidados Intensivos, Sanatorio Anchorena, Buenos Aires, Argentina.
Gustavo A PlotnikowServicio de Rehabilitación, Unidad de Terapia Intensiva, Hospital Britanico de Buenos Aires, Buenos Aires, Argentina.
Facundo BianchiniServicio de Rehabilitación, Unidad de Terapia Intensiva, Hospital Britanico de Buenos Aires, Buenos Aires, Argentina.
Matias AccoceVilla Lynch, Sanatorio Anchorena San Martin, Buenos Aires, Argentina.
Javier DoradoVilla Lynch, Sanatorio Anchorena San Martin, Buenos Aires, Argentina.
Savino SpadaroDepartment of Translational Medicine, University of Ferrara, Ferrara, Italy.
Riccardo La RosaDepartment of Translational Medicine, University of Ferrara, Ferrara, Italy.
Gwénael PratService de Réanimation Médicale, CHU de Brest, Brest, France.
Pierre BaillyRéanimation Médicale, CHU de Brest, Brest, France.ORCID http://orcid.org/0000-0001-8187-8672
Agathe DelboveRéanimation Polyvalente, Centre Hospitalier Bretagne Atlantique, Vannes, France.
Andrés Pacheco-ReyesVall d'Hebron University Hospital, Barcelona, Spain.
Oriol RocaServei de Medicina Intensiva, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain.
Khaldoun KuteifanService de Réanimation Médicale, GHRMSA, Mulhouse, France.
Anahita RouzéMédecine Intensive-Réanimation, CHU de Lille, Lille, France.
Domenico L GriecoDepartment of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Marta Izura-GómezIntensive Care Department, Critical Care Medicine Research Group, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Jordi ManceboServei Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Florian SigaudMédecine Intensive-Réanimation, CHU Grenoble Alpes, Grenoble, France.
Nicolas TerziMédecine Intensive-Réanimation, CHU Grenoble Alpes, Grenoble, France.
Clément SaccheriService de réanimation médicale, CHU Nice, Nice, France.
Jean DellamonicaMedical ICU, CHU Nice, Nice, France.
Jack RichecoeurRéanimation polyvalente, Beauvais Hospital, Beauvais, France.
Mariano SettenUnidad de Cuidados Intensivos, Norberto Quirno Center for Medical Education and Clinical Research, Buenos Aires, Argentina.
Michela RauseoDipartimento di Scienze Mediche e Chirurgiche, University of Foggia, Foggia, Italy.
François BeloncleDépartement de Médecine Intensive - Réanimation et Médecine hyperbare, Angers University Hospital, Angers, France.
Benjamin RepusseauService d'Anesthésie-Réanimation Thoraco-Abdominale, CHU de Bordeaux, Pessac, France.
Hadrien RozéRéanimation Polyvalente, Centre Hospitalier de la Cote Basque, Bayonne, France.
David Tran-VanService de Réanimation (Intensive Care Unit), Robert Picque Military Training Hospital, Villenave-d'Ornon, France.
Felipe DamianiEscuela de Ciencias de la Salud, Departamento de Kinesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Michel SlamaMedical Intensive Care Department, CHU Amiens-Picardie, Amiens, France.
David A KaufmanDivision of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, New York, USA.
Tommaso MaraffiRéanimation et Surveillance Continue Adulte, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Ewan C GoligherInterdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Gaëtan PlantefèveService de Médecine Intensive Réanimation, Centre Hospitalier d'Argenteuil, Argenteuil, France.ORCID http://orcid.org/0000-0003-3070-7368
Rogier DetermannDepartment of Intensive Care Medicine, OLVG, Amsterdam, Netherlands.
Melissa GiamouApplied Health Research Centre, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.
Tài PhamMédecine intensive-Réanimation, Hopital Bicetre, Le Kremlin-Bicêtre, France.
Lorenzo Del SorboInterdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Charles D G Keown-StonemanApplied Health Research Centre, Unity Health Toronto, Toronto, Ontario, Canada.
Rosane NisenbaumUniversity of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada.
Kevin ThorpeDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-7586-3893
Thomas PirainoDepartment of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
Lu ChenCentre of Excellence in Mechanical Ventilation, St Michael's Hospital Keenan Research Centre for Biomedical Science, Toronto, Ontario, Canada.
Peter JüniClinical Trial Service Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK.
Niall D FergusonInterdepartmental Division of Critical Care Medicine, Departments of Medicine and Physiology, Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
Arthur S SlutskyCentre of Excellence in Mechanical Ventilation, St Michael's Hospital Keenan Research Centre for Biomedical Science, Toronto, Ontario, Canada.
Laurent BrochardCentre of Excellence in Mechanical Ventilation, St Michael's Hospital Keenan Research Centre for Biomedical Science, Toronto, Ontario, Canada.
CAVIARDS study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAcute respiratory distress syndrome (ARDS) is a major public health problem, accounting for 23% of intubated patients and associated with high mortality rates. Although lifesaving, invasive mechanical ventilation can worsen lung injury when ventilator settings are poorly adjusted to lung physiology. We hypothesise that individualising ventilator settings via (1) the bedside assessment of lung recruitability using a one-breath derecruitment manoeuvre and measurement of airway opening pressure to set positive end-expiratory pressure (PEEP), (2) controlling the distending pressure and (3) controlling respiratory drive improves ARDS outcomes. METHODS AND ANALYSIS: The CAreful Ventilation In ARDS trial is an investigator-led multicentre (33 centres in eight countries), open-label, randomised controlled basket trial comparing two ventilation strategies in two subpopulations of moderate-to-severe ARDS: induced or not by COVID-19. A total of 740 patients will be randomised (370 in each substudy) in a 1:1 ratio to individualised ventilator settings or to using traditional PEEP to inspired fraction of oxygen tables for PEEP setting. Indications for proning and weaning strategies are similar in both arms. The primary outcome is all-cause mortality at day 60. Secondary outcomes include duration of mechanical ventilation, duration of intensive care unit (ICU) and hospital stay, organ dysfunction, barotrauma and mortality in ICU, at day 28 and in hospital. ETHICS AND DISSEMINATION: Ethics approval has been obtained for all participating centres: Unity Health Toronto Research Ethics Board (for three centres: St Michael's Hospital, Toronto General Hospital and Toronto Western Hospital); Comité de Ética de Investigación con Medicamentos del Hospital Universitari Vall d'Hebron; Comité de protection des personnes Ile de France III; Comité d'Ética de la Investigatción con Medicamentos de la Fundació de Gestió Sanitària del Hospital de la Santa Creu i Sant Pau; Comitato Etico-Fondazione Policlinico Gemelli; Comitato Etico di Area Vasta Emilia Centro; NYU Langone Health Institutional Review Board; Comité Ético Científico de Ciencias de la Salud; Il Comitato Etico Area 1 dell'Azienda Ospedaliero-Universitaria 'Ospedali Riuniti' di Foggia; HIGA 'Eva Perón' Comité de Bioética; Comité de Revisión Institucional del Hospital Británico Comité de Ética en Investigación; Complejo Médico Churruca-Visca Comité de Ética Biomédica; Comité de Ética SATI Comité de Ética en Investigación; Comité de Ética en Investigación del CEMIC; Comité de Ética SATI Comité de Ética en Investigación; Medical Research Ethics Committees United. Findings will be disseminated in peer review journals and conference presentations. TRIAL REGISTRATION NUMBER: NCT03963622.

Indexed as

COVID-19Positive-Pressure RespirationRespiration, ArtificialRespiratory Distress SyndromeHumansSARS-CoV-2Randomized Controlled TrialRespiratory Distress SyndromeVentilators, Mechanical

Identifiers

PMID41730551
PMCPMC12993348

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.