REDEEM Trial

A Randomised Controlled Trial of ECMO to De-sedate, Extubate Early, and Mobilise in Hypoxic Respiratory Failure

A Phase II Multicentre Randomised Controlled Trial

Aim: Our aim is to determine whether a strategy of adding ECMO to mechanical ventilation (as well as de-sedation, early extubation and mobilisation), as compared to conventional mechanical ventilation alone, will increase the number of intensive care free days at day 60, in patients with moderate to severe hypoxic respiratory failure.

Rationale: Patients placed on a mechanical ventilator in intensive care with severe lung disease (e.g. pneumonia) are at increased risk of dying and long-term health problems. The mechanical ventilator, whilst often lifesaving, can also lead to lung damage, and patients often require sedating medications to tolerate positive pressure ventilation. This can lead to a prolonged stay in the intensive care unit, secondary infections, weakness, and long-term reduction in physical function. There is a need to develop new treatments that support patients and at the same time reduce these potential complications. Extracorporeal membrane oxygenation (ECMO) is a device that supports the lungs by adding oxygen and removing carbon dioxide from the blood. It functions independently of the lung and mechanical ventilator, reducing the potential risk of lung damage, and also reduces the need for sedating medications so that activities like physiotherapy can begin earlier. The REDEEM trial is a randomised trial designed to explore whether adding ECMO compared to using the mechanical ventilator on its own, leads to an increase in the number of patients who survive and are discharged earlier from the intensive care unit. This ground-breaking multinational study has the potential to change the way we manage patients with moderate to severe lung disease who are admitted to intensive care.

Study Progress: Patient recruitment commenced in December 2022. A target of 140 patients will be enrolled at sites across Australia, and in Berlin, Germany.