Continuous-flow ventilation with VENTIJET in moderate ARDS: a pilot safety and feasibility study

BACKGROUND: Acute respiratory distress syndrome (ARDS) remains associated with high mortality and ventilator-induced lung injury. Continuous-flow ventilation (CFV) may reduce cyclic strain, but faced technical limitations. VENTIJET is a novel nozzle-based CFV ventilator designed for safe use in critically ill adults. This pilot study evaluated its feasibility and safety in patients with moderate ARDS. METHODS: We conducted a prospective, single-center pilot safety and feasibility study in intubated adults with moderate ARDS and stable oxygenation. After a 1-h baseline period with volume-controlled ventilation (Puritan Bennett™ 840), patients received up to 24 h of VENTIJET ventilation, then returned to conventional ventilation. Primary endpoints were feasibility and safety; secondary exploratory endpoints included gas exchange and respiratory mechanics. RESULTS: Fourteen patients were enrolled. VENTIJET ventilation was successfully delivered in all participants without protocol interruptions or device-related serious adverse events. After 1 h, PaO₂/FiO₂ was 200 mm Hg compared to 192 mm Hg at baseline (p = 0.090). Over 24 h, oxygenation and respiratory system compliance showed modest improvement, with stable carbon dioxide (CO₂) elimination, transpulmonary pressures, and hemodynamics. CONCLUSIONS: In patients with moderate ARDS, VENTIJET CFV was feasible and safe, maintaining stable gas exchange with modest improvements in respiratory mechanics. These findings support further evaluation in larger, controlled trials, including the full spectrum of ARDS. Trial registration ClinicalTrials.gov Identifier NCT07121257.