Does one of several investigational therapies improve all-cause mortality in adult patients admitted to the ICU for severe community-acquired pneumonia who are undergoing organ support?
Patient Type
COVID, Ventilated
INTERVENTION Type
Ventilation
GROUP A
Protocolized mechanical ventilation
GROUP B
The physician-preferred mechanical ventilation
INCLUSION CRITERIA
1. Adult patient admitted to an ICU for acute severe CAP within 48 hours of hospital admission with
a. symptoms or signs or both that are consistent with lower respiratory tract infection (for example, acute onset of dyspnea, cough, pleuritic chest pain) AND
b. Radiological evidence of new onset infiltrate of infective origin (in patients with pre-existing radiological changes, evidence of new infiltrate)
2. Up to 48 hours after ICU admission, receiving organ support with one or more of:
a. Non-invasive or invasive ventilatory support;
b. Receiving infusion of vasopressor or inotropes or both
INCLUSION TIME LIMIT
24-48 hours depending of the domain
EXCLUSION CRITERIA
1. Healthcare-associated pneumonia:
a. Prior to this illness, is known to have been an inpatient in any healthcare facility within the last 30 days
b. Resident of a nursing home or long-term care facility
2. Death is deemed to be imminent and inevitable during the next 24 hours AND one or more of the patient, substitute decision maker or attending physician are not committed to full active treatment
3. Previous participation in this REMAP within the last 90 days
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