- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00678912
Weaning Children From Mechanical Ventilation:Computer-driven System Versus Usual Care
Single Center Randomized Clinical Trial Comparing Weaning From Mechanical Ventilation With Computer-driven System vs Usual Care in Children
Study Overview
Detailed Description
Baseline data: All subjects included into this RCT will undergo routine examination upon admission to the hospital. These examinations include physical, medical/medication history (on the last year for medical history and the last 3 months for medication history (if available), vital signs, radiologic data and laboratory tests.
Intervention: A pre-inclusion test (pressure support test) with a level of pressure support of ± 5 cmH2O of the P plateau, but no greater than 30 cmH2O (pressure-support level plus positive end-expiratory pressure), is performed to evaluate the patient's tolerance of this ventilation mode; the test is repeated daily until positive. The test could be stopped before 30 minutes if the patient showed evidence of respiratory distress (respiratory rate > 40 breaths per minute and FiO2 > 60% in order to obtain pulse oxymetry ≥ 95%). The test is considered positive when, after 30 minutes, the patient remained clinically stable with a respiratory rate lower than 40 breaths per minute and an expiratory tidal volume higher than 6 ml per kilogram of body weight within the authorized pressure-support range, with pulse oxymetry no lower than 95 percent when the fraction of inspired oxygen was no greater than 60 percent. When the pressure-support test is positive, the patient is randomized either to Arm 1 where the intervention is weaning with the support of Smartcare/PS or to Arm 2 where the intervention is weaning based on usual care. Both group are ventilated with the same ventilator: Evita XL.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
Quebec
-
Montreal, Quebec, Canada, H3T 1C5
- CHU Sainte Justine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- The attending physician thinks that the patient will be able to breathe spontaneously or the patients is already breathing spontaneously.
- No vasopressor or inotropic medication, unless the patient is receiving some digitalin or small doses of dopamine (< 5 µg/kg/min)
- Slight or no endotracheal tube gas-leakage ([Vti - Vte]/Vti ≤ 20%)
- Mechanical ventilation with a plateau pressure ≤ 25 cmH2O over PEEP
- PEEP ≤ 8 cmH2O
- FiO2 ≤ 60% in order to obtain pulse oxymetry ≥ 95%
- PaCO2 < 70 mmHg on the last blood gases
- Extubation not expected the day of inclusion
Exclusion Criteria:
- N/A
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1
Children are mechanically ventilated with Smartcare/PS
|
computer-driven protocol that adjusts pressure support level in pressure support mode to patient respiratory status
Other Names:
|
No Intervention: 2
Children are mechanically ventilated with usual care
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Length of weaning from mechanical ventilation that corresponds to the time from Time 0 to the first extubation.
Time Frame: first extubation or 28 days
|
first extubation or 28 days
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Total mechanical ventilation duration
Time Frame: first extubation or 28 days
|
first extubation or 28 days
|
Proportion of time in the acceptable breathing zone
Time Frame: first extubation or 28 days
|
first extubation or 28 days
|
Weaning failure
Time Frame: 48 hours after first extubation
|
48 hours after first extubation
|
Number of interventions on the ventilator by a physician or physiotherapist
Time Frame: First extubation or 28 days
|
First extubation or 28 days
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Philippe A Jouvet, MD PhD, Université de Montréal
Publications and helpful links
General Publications
- Jouvet P, Farges C, Hatzakis G, Monir A, Lesage F, Dupic L, Brochard L, Hubert P. Weaning children from mechanical ventilation with a computer-driven system (closed-loop protocol): a pilot study. Pediatr Crit Care Med. 2007 Sep;8(5):425-32. doi: 10.1097/01.PCC.0000282157.77811.F9.
- Jouvet PA, Payen V, Gauvin F, Emeriaud G, Lacroix J. Weaning children from mechanical ventilation with a computer-driven protocol: a pilot trial. Intensive Care Med. 2013 May;39(5):919-25. doi: 10.1007/s00134-013-2837-8. Epub 2013 Jan 30.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CHUSJ-2239
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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