Trial Outcomes & Findings for Mode Of Ventilation During Critical IllnEss Pilot Trial (NCT NCT05563779)

NCT ID: NCT05563779

Last Updated: 2026-02-23

Results Overview

Number of days alive and free from invasive mechanical ventilation between the final liberation from invasive mechanical ventilation before 28 days and study day 28. Patients who continue to receive invasive mechanical ventilation at day 28 or have died prior to day 28 will receive zero VFDs. For patients who return to invasive mechanical ventilation and are subsequently liberated from invasive mechanical ventilation prior to day 28, VFDs will be counted from final liberation from mechanical ventilation.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

566 participants

Primary outcome timeframe

Enrollment to 28 days

Results posted on

2026-02-23

Participant Flow

During the 9 months of enrollment in the MODE trial, the entire medical ICU will be assigned to a single ventilator mode with the assigned mode alternating between volume control, pressure control, and adaptive pressure control modes every month in a randomly generated sequence. All patients who receive invasive mechanical ventilation and meet inclusion criteria without meeting exclusion criteria will be enrolled. The study mode will be assigned according to the month of enrollment.

Patients will be assigned to only the mode of ventilation at enrollment and analyzed according to the assigned mode. If patients continue to receive mechanical ventilation at the start of the next study block, choice of the ventilator mode will be at the discretion of clinicians. Patients will not crossover to another mode of ventilation. Participation ends at the first of hospital discharge or death.

Participant milestones

Participant milestones
Measure
Volume Control Mode
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Overall Study
STARTED
181
198
187
Overall Study
COMPLETED
181
198
187
Overall Study
NOT COMPLETED
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Mode Of Ventilation During Critical IllnEss Pilot Trial

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Total
n=566 Participants
Total of all reporting groups
Age, Continuous
59.9 Years
n=58 Participants
56.9 Years
57.7 Years
n=1 Participants
57.0 Years
n=5 Participants
Sex: Female, Male
Female
82 Participants
n=58 Participants
81 Participants
71 Participants
n=1 Participants
234 Participants
n=5 Participants
Sex: Female, Male
Male
99 Participants
n=58 Participants
117 Participants
116 Participants
n=1 Participants
332 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=58 Participants
1 Participants
3 Participants
n=1 Participants
5 Participants
n=5 Participants
Race (NIH/OMB)
Asian
3 Participants
n=58 Participants
2 Participants
3 Participants
n=1 Participants
8 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=58 Participants
0 Participants
0 Participants
n=1 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
31 Participants
n=58 Participants
28 Participants
35 Participants
n=1 Participants
94 Participants
n=5 Participants
Race (NIH/OMB)
White
138 Participants
n=58 Participants
153 Participants
133 Participants
n=1 Participants
424 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=58 Participants
0 Participants
0 Participants
n=1 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
8 Participants
n=58 Participants
14 Participants
13 Participants
n=1 Participants
35 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
7 Participants
n=58 Participants
11 Participants
8 Participants
n=1 Participants
26 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
169 Participants
n=58 Participants
176 Participants
169 Participants
n=1 Participants
514 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
5 Participants
n=58 Participants
11 Participants
10 Participants
n=1 Participants
26 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Enrollment to 28 days

Number of days alive and free from invasive mechanical ventilation between the final liberation from invasive mechanical ventilation before 28 days and study day 28. Patients who continue to receive invasive mechanical ventilation at day 28 or have died prior to day 28 will receive zero VFDs. For patients who return to invasive mechanical ventilation and are subsequently liberated from invasive mechanical ventilation prior to day 28, VFDs will be counted from final liberation from mechanical ventilation.

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Ventilator-free Days (VFDs) to Day 28 After Enrollment
23 Ventilator-free days to day 28
Interval 0.0 to 26.0
22 Ventilator-free days to day 28
Interval 0.0 to 26.0
24 Ventilator-free days to day 28
Interval 0.0 to 26.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 72 hours

Population: Data not available for 3 patients: 1 in Volume Control group and 2 in Adaptive Pressure Control group.

Percentage of time in the assigned mode while receiving invasive mechanical ventilation in the study ICU between enrollment and 72 hours after enrollment.

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=180 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=185 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Exposure to Assigned Study Mode in First 3 Days (Feasibility Outcome)
87.5 Percentage of time
Interval 61.0 to 98.4
90.2 Percentage of time
Interval 56.6 to 98.9
93.8 Percentage of time
Interval 74.2 to 99.7

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 72 hours

Population: Sixteen patients did not have a recorded mandatory mode of ventilation during the study period from enrollment to death or extubation: 5 in Volume Control group, 4 in Pressure Control group, and 7 in Adaptive Pressure Control group.

Percentage of time in the assigned mode while receiving invasive mechanical ventilation in the study ICU with a mandatory mode between enrollment and 72 hours after enrollment (excluding time spent in spontaneous modes).

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=176 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=194 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=180 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Adherence to Study Mode in First 3 Days (Feasibility Outcome)
100.0 Percentage of time
Interval 100.0 to 100.0
100.0 Percentage of time
Interval 98.9 to 100.0
100.0 Percentage of time
Interval 100.0 to 100.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 28 days

Population: Nineteen patients did not have receipt of the assigned study mode recorded from enrollment to death or extubation: 7 in Volume Control group, 5 in Pressure Control group, and 7 in Adaptive Pressure Control group.

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=174 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=193 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=180 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Time From Enrollment to Initiation of Assigned Mode of Mechanical Ventilation (Feasibility Outcome)
5.2 Hours
Interval 1.7 to 16.6
5.2 Hours
Interval 1.4 to 17.1
4.6 Hours
Interval 0.8 to 15.1

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 28 days

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Number of Patients With a "Mode Modification Sheet" Completed by Treating Clinicians (Feasibility Outcome)
19 Participants
25 Participants
4 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to the first of extubation, 28 days, or death

Population: No tidal volume data were available for one patient in the Adaptive Pressure Control group.

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=186 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Exhaled Tidal Volume (mL/kg Predicted Body Weight) (Exploratory Efficacy and Safety Outcome)
6.2 mL / kg of predicted body weight
Interval 5.9 to 7.1
6.4 mL / kg of predicted body weight
Interval 5.8 to 7.4
6.2 mL / kg of predicted body weight
Interval 5.9 to 6.9

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to the first of extubation, 28 days, or death

Population: Tidal volume data were not available for one patient in the Adaptive Pressure Control group.

Percentage of exhaled tidal volume values above target range (\>8mL/kg predicted body weight), reported as a percentage.

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=186 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Percentage of Exhaled Tidal Volumes Above Target Range (Exploratory Efficacy and Safety Outcome)
0.0 Percentage of time
Interval 0.0 to 8.3
6.8 Percentage of time
Interval 0.0 to 31.4
3.6 Percentage of time
Interval 0.0 to 14.3

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to the first of 28 days or death

Hypoxemia during mechanical ventilation defined as an SpO2 \<85% for more than 5 minutes

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Hypoxemia During Mechanical Ventilation (Exploratory Safety and Efficacy Outcome)
21 Participants
20 Participants
14 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 28 days

Severe acidemia during mechanical ventilation: pH \< 7.1 on blood gas

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Severe Acidemia During Mechanical Ventilation (Exploratory Safety and Efficacy Outcome)
22 Participants
21 Participants
14 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 1 day

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Number of Blood Gas Laboratory Tests on the First Study Day (Exploratory Safety and Efficacy Outcome)
3 count of blood gas laboratory tests
Interval 1.0 to 5.0
2 count of blood gas laboratory tests
Interval 1.0 to 5.0
3 count of blood gas laboratory tests
Interval 1.0 to 5.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 28 days

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Pneumomediastinum or Pneumothorax During Mechanical Ventilation (Exploratory Efficacy and Safety Outcome)
4 Participants
6 Participants
1 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 1 day

Population: Insufficient data were available for four patients: 2 patients in the Volume Control group and 2 patients in the Pressure Control group.

The Sequential Organ Failure Assessment (SOFA) score is composed of scores from six organ systems, graded from 0 to 4 according to the degree of dysfunction or failure. Scores range from 0 (no evidence of organ dysfunction or failure) to 24 (evidence of severe organ dysfunction or failure). The mean of SOFA scores on study day 1 was calculated for each patient.

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=179 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=196 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
SOFA Score on the First Study Day (Exploratory Safety and Efficacy Outcome)
11.0 SOFA Score
Interval 8.4 to 13.9
11.9 SOFA Score
Interval 8.5 to 14.0
11.0 SOFA Score
Interval 8.4 to 13.9

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 28 days

Number of days alive and without delirium or coma before 28 days to study day 28

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Delirium and Coma Free Days to Day 28 (Exploratory Efficacy and Safety Outcome)
21 Delirium and coma-free days to day 28
Interval 0.0 to 26.0
18 Delirium and coma-free days to day 28
Interval 0.0 to 26.0
22 Delirium and coma-free days to day 28
Interval 0.0 to 26.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 28 days

Number of days alive and free from intensive care unit admission after the final transfer out of the intensive care unit before 28 days to study day 28

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Intensive Care Unit-free Days to Study Day 28 (Exploratory Clinical Outcome)
21 ICU-free days to day 28
Interval 0.0 to 25.0
19 ICU-free days to day 28
Interval 0.0 to 25.0
21 ICU-free days to day 28
Interval 0.0 to 25.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 28 days

Number of days alive and free from hospitalization after the final transfer out of the hospital before 28 days to study day 28

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
Hospital-Free Days to Study Day 28 (Exploratory Clinical Outcome)
8 Hospital-free days to day 28
Interval 0.0 to 19.0
7 Hospital-free days to day 28
Interval 0.0 to 20.0
9 Hospital-free days to day 28
Interval 0.0 to 21.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrollment to 28 days

All-cause mortality prior to discharge from the hospital, assessed at 28 days after enrollment

Outcome measures

Outcome measures
Measure
Volume Control Mode
n=181 Participants
During invasive mechanical ventilation in a study location, Volume Control will be used as the mode for continuous mandatory ventilation.
Pressure Control Mode
n=198 Participants
During invasive mechanical ventilation in a study location, Pressure Control will be used as the mode for continuous mandatory ventilation.
Adaptive Pressure Control Mode
n=187 Participants
During invasive mechanical ventilation in a study location, Adaptive Pressure Control will be used as the mode for continuous mandatory ventilation.
In-hospital Mortality to Study Day 28 (Exploratory Clinical Outcome)
59 Participants
67 Participants
60 Participants

Adverse Events

Volume Control Mode

Serious events: 0 serious events
Other events: 0 other events
Deaths: 59 deaths

Pressure Control Mode

Serious events: 0 serious events
Other events: 0 other events
Deaths: 67 deaths

Adaptive Pressure Control Mode

Serious events: 0 serious events
Other events: 0 other events
Deaths: 60 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Kevin P Seitz, MD

Vanderbilt University Medical Center

Phone: 615-936-9329

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place