title: Beta Agonist Lung Injury TrIal-2 (BALTI-2) trial protocol: a randomised, double-blind, placebo-controlled of intravenous infusion of salbutamol in the acute respiratory distress syndrome.
abstract: BACKGROUND
  The acute respiratory distress syndrome (ARDS) is a common cause of respiratory failure in critically ill patients. Experimental studies suggest that treatment with beta agonists may be helpful in ARDS. The Beta Agonist Lung Injury TrIal (BALTI-2) is a multicentre, pragmatic, randomised, double-blind, placebo-controlled clinical trial which aims to determine if sustained treatment with intravenous (IV) salbutamol will improve survival in ARDS.
  
  
  METHODS
  Patients fulfilling the American-European Consensus Conference Definition of ARDS will be randomised in a 1:1 ratio to receive an IV infusion either of salbutamol (15 μg kg ideal body weight-1 hr-1) or placebo (0.9% sodium chloride solution), for a maximum of seven days. Allocation to randomised groups will use minimisation to ensure balance with respect to hospital of recruitment, age group (<64, 65-84, >85 years) and PaO2/FiO2 ratio (≤6.7, 6.8- 13.2, ≥13.3 kPa). Data will be recorded by participating ICUs until hospital discharge, and all surviving patients will be followed up by post at six and twelve months post randomisation. The primary outcome is mortality at 28 days after randomisation; secondary outcomes are mortality in ICU, mortality in hospital, number of ventilator-free days, number of organ failure-free days, mortality at twelve months post-randomisation, quality of life at six and twelve months, length of stay in ICU, length of stay in hospital, adverse effects (tachycardia, arrhythmia or other side effects sufficient to stop treatment drug). 1,334 patients will be recruited from about fifty ICUs in the UK. An economic evaluation will be conducted alongside the trial.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN38366450.
authors.affiliation: University of Warwick, Warwick Medical School Clinical Trials Unit, Warwick, CV4 7AL, UK. g.d.perkins@warwick.ac.uk
authors.forename: Gavin D
authors.initials: GD
authors.lastname: Perkins
authors.forename: Simon
authors.initials: S
authors.lastname: Gates
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Lamb
authors.forename: Chris
authors.initials: C
authors.lastname: McCabe
authors.forename: Duncan
authors.initials: D
authors.lastname: Young
authors.forename: Fang
authors.initials: F
authors.lastname: Gao
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D000420:Albuterol / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D016527:Drug Costs; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D015990:Placebo Effect; D012107:Research Design; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D000420:Albuterol