Adaptive minute ventilation during intrahospital transport: study protocol for a randomized controlled trial

Intra-hospital transport of critically ill, mechanically ventilated patients is associated with significant physiological risks. Adaptive Minute Ventilation (AMV) is a closed-loop ventilation mode that automatically maintains target minute ventilation. While AMV has shown promise in intensive care unit settings, its performance during intrahospital transport has not yet been evaluated. This trial aims to assess the safety and efficacy of AMV compared with conventional ventilation strategies during patient transport.

This is a single-centre, open-label, randomized controlled non-inferiority trial conducted at Peking Union Medical College Hospital. Fifty adult patients receiving invasive mechanical ventilation and requiring transport will be randomly assigned (1:1) to either AMV or their pre-transport ventilation mode. The primary endpoint is the change in arterial carbon dioxide pressure (PaCO₂) from 30 min before to 10 min after transport. Secondary outcomes include changes in oxygenation index (PaO₂/FiO₂), peak airway pressure, dynamic compliance, and rapid shallow breathing index. Randomization will be performed using permuted block randomization. Both intention-to-treat and per-protocol analyses will be conducted. Missing data will be handled using multiple imputation. The study protocol has been reviewed and approved by the Ethics Committee of Peking Union Medical College Hospital (Approval No. I-25PJ0781). It was registered in the Chinese Clinical Trial Registry (ChiCTR2500109659) on 23 September 2025 as a retrospective registration.

This trial will be the first randomized study to evaluate AMV during intrahospital transport of critically ill patients. The findings will address an important evidence gap in transport ventilation strategies, potentially informing clinical practice on whether AMV provides a safe and effective alternative to conventional modes. By employing a non-inferiority design and standardized transport protocols, the study seeks to generate robust and clinically relevant evidence despite its single-centre setting and relatively small sample size.

Approved by the Ethics Committee of Peking Union Medical College Hospital (Approval No. I-25PJ0781).

ChiCTR, ChiCTR2500109659. Registered 23 September 2025, https://www.chictr.org.cn/hvshowproject.html?id=284847 .