ClinicalTrials.gg
Not yet recruitingNCT07791225VV (A)Updated Aug 27, 2026

The Variable Ventilation Trial (Part A)

An interventional study of Variable Ventilation and Conventional Ventilation in ARDS (Acute Respiratory Distress Syndrome), sponsored by Brigham and Women's Hospital. Not yet recruiting at 5 sites in United States. Open to participants aged 21 Years and older. Per ClinicalTrials.gov, last updated 2026-08-27.

Sponsored by Brigham and Women's Hospital · Not applicable, Interventional, and Treatment

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Phase
Not applicable
Study type
Interventional
Enrollment
20
Allocation
Non-randomized
Ages
21 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 112 studies in Acute Lung Injury with a site in United States — 17 open to participants now, 19 under way, 1 of them phase 3. Acute Lung Injury · United States.

Planned enrollment
61st of 88
20 · median 68
Started
2027
with 1 other
No phase
21 of 112
4 open now
Primary completion
2031-02
later than 16 of 18 live
Registered
112th of 112
by date

Among the 112 studies in Acute Lung Injury with a site in United States, this one is the 61st largest by planned enrollment of the 88 interventional ones that give a count, is one of 2 that started in 2027, is one of 21 with no phase, reaches primary completion later than 16 of the 18 other live ones, and was the 112th registered.

Acute Lung Injury

382 studies on the registry are indexed under Acute Lung Injury; 73 are open to participants now.

Browse Acute Lung Injury studies →

Open to participants now

17 of the 112 studies in Acute Lung Injury with a site in United States are open now. Recruiting first, the newest first:

11 more — sign in →

All 17 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 45 Acute Lung Injury studies recruiting now, 25 (56%) set no upper age limit and 8 (18%) stop at 75 or younger; 6 take children under 18; 7 take healthy volunteers.

This study: 21 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 112 studies in Acute Lung Injury with a site in United States, or all of them as a file.
02

Study summary

The goal of this clinical trial is to learn if a breathing machine (ventilator) method called "variable ventilation" can help protect the lungs of adult patients with acute respiratory distress syndrome (ARDS) who need help breathing through a ventilator. In variable ventilation, the size of each breath given by the machine changes slightly from breath to breath, instead of staying the same size in every breath. The study has two parts, A (safety and feasibility) and B (efficacy). This entry will cover the part A (safety study).

The main questions part A aims to answer are:

  1. Is variable ventilation safe to use in adults with ARDS?
  2. Is it feasible to deliver this method of ventilation to patients?

Researchers will compare variable ventilation to the standard breathing machine method used today to see if variable ventilation is safe and feasible.

Participants will be placed on an FDA approved ventilator that can deliver conventional mechanical ventilation and variable ventilation. Participants will:

  • Have a period of stabilization on conventional ventilation, followed by 24 hours of variable ventilation, followed by 24 hours of conventional ventilation.
  • Be checked regularly for breathing, oxygen levels, lung function, and plasma biomarkers.
03

Conditions studied

  • ARDS (Acute Respiratory Distress Syndrome)

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04

Who can participate

Ages eligible
21 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Patients ≥21 years old admitted to the Surgical, Trauma, Burn, Coronary or Medical ICUs with ARDS according to the Berlin criteria [50] and requiring mechanical ventilation will be eligible for inclusion.
  2. Not more than 96 hours of mechanical ventilation before randomization
  3. Anticipated need for at least 48 more hours of controlled mechanical ventilation
  4. Intubated and mechanically ventilated for ARDS according to the Berlin criteria

    • Hypoxemia of acute onset, within the past 7 days
    • Mild or moderate hypoxemia, PaO2/FiO2 ratio 100 - 300 mm Hg
    • Presence of a risk factor for ARDS
    • Respiratory failure not fully explained by cardiac failure or fluid overload
    • Bilateral opacities not explained by effusions, lobar collapse, or nodules

Exclusion criteria

Exclusion Criteria:

Demographic

  1. Age less than 21 years
  2. Pregnant or breastfeeding
  3. Prisoner
  4. Concurrent participation in another drug study
  5. Patient, surrogate, or physician not committed to full support (exception: a patient will not be excluded if they would receive all supportive care except for attempts at resuscitation from cardiac arrest)
  6. No consent or inability to obtain consent or appropriate legal representative not available
  7. Physician refusal to allow enrollment in the trial
  8. Moribund patient not expected to survive 24 hours
  9. Treating team unwilling to use ARDS network low tidal volume strategy or variable ventilation mode
  10. Use, or planned use of ECMO
  11. Stroke (ischemic or hemorrhagic) or traumatic brain injury (TBI) within the prior 3 months
  12. Burns > 40% total body surface area (TBSA)
  13. Severe airway inhalational injury
  14. Diffuse alveolar hemorrhage
  15. Any of the following hallmarks of Severe , Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 3 or 4

    1. \< 50% predicted
    2. Resting arterial blood gas values PaO2\<55, SaO2\<88%, or PaCO2>55
    3. Home invasive or non-invasive ventilation other than for sleep apnea
    4. Cor Pulmonale
    5. Candidate for, or has received, lung volume reduction surgery, bronchoscopic intervention to reduce end-expiratory lung volume, or lung transplantation
  16. Any of the following cardiac problems:

    1. Acute myocardial infarction (MI) or acute coronary syndrome within the last 90 days
    2. Coronary artery bypass graft (CABG) surgery within 30 days
    3. Angina pectoris, or use of nitrates, with activities of daily living
    4. Cardiopulmonary disease classified as class IV

    Physiological Exclusions

  17. Evidence of current barotrauma (e.g., pneumothorax, pneumomediastinum, or subcutaneous emphysema)
  18. Hemodynamic instability defined by inability to maintain a mean arterial pressure > 60 mm Hg.
  19. Other respiratory instability PEEP ≥18 cmH2O, suctioning more than hourly, Pplateau > 35 cm H2O, severe respiratory acidosis pH\<7.25.
  20. Increased ICP > 20 cmH2O or mechanism of injury leading to concern for increased ICP
  21. Active bleeding with hemodynamic instability.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
20 participants (estimated)

Study arms

  • Experimental
    Variable Ventilation

    Strategy of mechanical ventilation based on varying tidal volume breath to breath to provide therapeutic benefits in patients with ARDS. The variable ventilation (VV) strategy will be implemented on a commercially available ventilator.

    Device: Variable Ventilation

  • Placebo comparator
    Conventional Ventilation

    Standard strategy of mechanical ventilation based on constant size low tidal volume implemented on a commercially available ventilator.

    Device: Conventional Ventilation

Interventions

  • DeviceVariable Ventilation

    Strategy of mechanical ventilation based on varying tidal volume breath to breath to provide therapeutic benefits in patients with ARDS.

  • DeviceConventional Ventilation

    Strategy of mechanical ventilation based on delivery of a constant size low tidal volume.

06

What researchers measure

Primary outcomes

  1. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    Barotrauma

    Time frame: Maximum of 24 hours of VV

  2. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    Worsening Hypoxemia

    Time frame: Maximum of 24 hours of VV

  3. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    Worsening ventilation

    Time frame: Maximum of 24 hours of VV

  4. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    New onset arrhythmia requiring cardioversion

    Time frame: Maximum of 24 hours of VV

  5. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    Hemodynamic instability

    Time frame: Maximum of 24 hours of VV

  6. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    ST-segment elevation myocardial infarction

    Time frame: Maximum of 24 hours of VV

  7. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    Self-extubation

    Time frame: Maximum of 24 hours of VV

  8. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    Stroke

    Time frame: Maximum of 24 hours of VV

  9. Safety assessed by the incidence of pre-specified AEs over the first 24 hours

    Death

    Time frame: Maximum of 24 hours of VV

Secondary outcomes

  1. Lung mechanics

    Lung compliance, airways resistance, peak and plateau pressures

    Time frame: Every 12 hours to maximum of 24 hours of VV

  2. Gas exchange

    SpO2, PaO2/FiO2 ratio, oxygenation index, dead space, and lung injury score.

    Time frame: Every 12 hours to maximum of 24 hours of VV

  3. Feasibility of VV implementation.

    Qualitative feedback from Research and Clinical staff of the device and implementation in the ICU setting.

    Time frame: Every 12 hours during 24 hours of VV

07

Study locations

5 sites
08

References and documents

Publications

  • Pillow JJ, Musk GC, McLean CM, Polglase GR, Dalton RG, Jobe AH, Suki B. Variable ventilation improves ventilation and lung compliance in preterm lambs. Intensive Care Med. 2011 Aug;37(8):1352-9. doi: 10.1007/s00134-011-2237-x. Epub 2011 May 13. PubMed 21567115 ↗
  • Suki B, Parameswaran H, Imsirovic J, Bartolak-Suki E. Regulatory Roles of Fluctuation-Driven Mechanotransduction in Cell Function. Physiology (Bethesda). 2016 Sep;31(5):346-58. doi: 10.1152/physiol.00051.2015. PubMed 27511461 ↗
  • Berry CA, Suki B, Polglase GR, Pillow JJ. Variable ventilation enhances ventilation without exacerbating injury in preterm lambs with respiratory distress syndrome. Pediatr Res. 2012 Oct;72(4):384-92. doi: 10.1038/pr.2012.97. Epub 2012 Jul 17. PubMed 22805999 ↗
  • Bartolak-Suki E, Imsirovic J, Parameswaran H, Wellman TJ, Martinez N, Allen PG, Frey U, Suki B. Fluctuation-driven mechanotransduction regulates mitochondrial-network structure and function. Nat Mater. 2015 Oct;14(10):1049-57. doi: 10.1038/nmat4358. Epub 2015 Jul 27. PubMed 26213900 ↗
  • Arold SP, Bartolak-Suki E, Suki B. Variable stretch pattern enhances surfactant secretion in alveolar type II cells in culture. Am J Physiol Lung Cell Mol Physiol. 2009 Apr;296(4):L574-81. doi: 10.1152/ajplung.90454.2008. Epub 2009 Jan 9. PubMed 19136581 ↗
  • Pillow JJ, Bartolak-Suki E, Noble PB, Berry CA, Suki B. Surfactant Protein Production during Maturation Is Enhanced by Natural Variability in Breathing. Am J Respir Cell Mol Biol. 2023 Jul;69(1):115-118. doi: 10.1165/rcmb.2022-0411LE. No abstract available. PubMed 37387612 ↗
  • Bellardine CL, Hoffman AM, Tsai L, Ingenito EP, Arold SP, Lutchen KR, Suki B. Comparison of variable and conventional ventilation in a sheep saline lavage lung injury model. Crit Care Med. 2006 Feb;34(2):439-45. doi: 10.1097/01.ccm.0000196208.01682.87. PubMed 16424726 ↗
  • Arold SP, Suki B, Alencar AM, Lutchen KR, Ingenito EP. Variable ventilation induces endogenous surfactant release in normal guinea pigs. Am J Physiol Lung Cell Mol Physiol. 2003 Aug;285(2):L370-5. doi: 10.1152/ajplung.00036.2003. PubMed 12851212 ↗
  • Thammanomai A, Hueser LE, Majumdar A, Bartolak-Suki E, Suki B. Design of a new variable-ventilation method optimized for lung recruitment in mice. J Appl Physiol (1985). 2008 May;104(5):1329-40. doi: 10.1152/japplphysiol.01002.2007. Epub 2008 Mar 13. PubMed 18339891 ↗
  • Bartolak-Suki E, Noble PB, Bou Jawde S, Pillow JJ, Suki B. Optimization of Variable Ventilation for Physiology, Immune Response and Surfactant Enhancement in Preterm Lambs. Front Physiol. 2017 Jun 23;8:425. doi: 10.3389/fphys.2017.00425. eCollection 2017. PubMed 28690548 ↗
  • Thammanomai A, Hamakawa H, Bartolak-Suki E, Suki B. Combined effects of ventilation mode and positive end-expiratory pressure on mechanics, gas exchange and the epithelium in mice with acute lung injury. PLoS One. 2013;8(1):e53934. doi: 10.1371/journal.pone.0053934. Epub 2013 Jan 9. PubMed 23326543 ↗
  • Suki B, Alencar AM, Sujeer MK, Lutchen KR, Collins JJ, Andrade JS Jr, Ingenito EP, Zapperi S, Stanley HE. Life-support system benefits from noise. Nature. 1998 May 14;393(6681):127-8. doi: 10.1038/30130. No abstract available. PubMed 9603516 ↗
  • Arold SP, Mora R, Lutchen KR, Ingenito EP, Suki B. Variable tidal volume ventilation improves lung mechanics and gas exchange in a rodent model of acute lung injury. Am J Respir Crit Care Med. 2002 Feb 1;165(3):366-71. doi: 10.1164/ajrccm.165.3.2010155. PubMed 11818322 ↗
  • Dellaca RL, Aliverti A, Lo Mauro A, Lutchen KR, Pedotti A, Suki B. Correlated variability in the breathing pattern and end-expiratory lung volumes in conscious humans. PLoS One. 2015 Mar 24;10(3):e0116317. doi: 10.1371/journal.pone.0116317. eCollection 2015. PubMed 25803710 ↗

Individual participant data

Plan to share: No — We will only be sharing data in agregate.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Feb 2027; primary completion for Feb 2031, 48 months later.

Of 51 non-industry interventional studies with no phase under Acute Lung Injury, half reached primary completion within 15 months of starting (the median), counting those still running; a quarter within 7 and three quarters within 34. This study's planned 48 months is above that.

Counting every sponsor, half of 52 studies reached it within 15 months; a quarter within 7 and three quarters within 34.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 25, 2026
First posted
Aug 27, 2026
StartEst.
Feb 1, 2027
Primary completionEst.
Feb 1, 2031
CompletionEst.
Aug 31, 2031
Last update
Aug 27, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07791225
Responsible party
Rebecca Baron (Associate Professor of Medicine, Brigham and Women's Hospital) — Principal investigator
First posted
Aug 27, 2026
Start date
Feb 1, 2027 (estimated)
Primary completion
Feb 1, 2031 (estimated)
Completion
Aug 31, 2031 (estimated)
Last update
Aug 27, 2026

Study contacts

Rebecca Baron, MD
Contact
rbaron@bwh.harvard.edu
617-525-6642
Rebecca Baron, MD
principal investigator · Brigham and Women's Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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