Automated Ventilator Controlled Weaning vs Daily Spontaneous Breathing Trial in Difficult to Wean ICU Patients

Comparison of Automated Ventilator Controlled Weaning to Daily Spontaneous Breathing Trial Weaning Protocol in ICU Patients Following Prolonged Mechanical Ventilation.

This study will compare Drager Smart Care (SC), a commercially available automated ventilator controlled weaning mode to the current daily spontaneous breathing trial (SBT) weaning protocol. The study is designed to determine if automated ventilator controlled weaning can reduce total duration of intubation following mechanical ventilation in ICU patients requiring prolonged mechanical ventilation (>72 hours).

Study Overview

Status

Withdrawn

Intervention / Treatment

Study Type

Interventional

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • California
      • San Francisco, California, United States, 94110
        • San Francisco General Hospital, UCSF Dept. of Anesthesia

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age ≥ 18 years
  • Intubated with endotracheal tube
  • Requiring mechanical ventilation for > 72 hours
  • Meets weaning criteria: Improvement or resolution of the underlying process that precipitated need for mechanical ventilation, PaO2 ≥ 60 mm Hg on PEEP and FiO2 Requirements of ≤ 8 cm H2O and FiO2 ≤ 0.50, Stable oxygenation: PEEP and FiO2 requirements not increased in the past 24 hrs, Ability to initiate an inspiratory effort and trigger the ventilator, Subject enrollment approved by the primary service attending physician

Exclusion Criteria:

  • Pregnancy
  • Patients with tracheostomy or planned tracheostomy prior to attempt to extubate
  • Patients with known airway patency issues that are anticipated to delay extubation.
  • Patients with neurological injury in whom care is likely to be withdrawn
  • Patients with cervical spinal cord injury.
  • Prospective subject or surrogate consenter does not fully understand the implications of the study because of a language barrier.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

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 SmartCare
automated ventilator controlled adjustment of pressure support
daily SmartCare vs SBT until extubation criteria met
Active Comparator: 2 spontaneous breathing Trial
daily SBT on minimum pressure support
daily SmartCare vs SBT until extubation criteria met

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
weaning time to successful spontaneous breathing trial
Time Frame: 28 days or extubation
28 days or extubation
weaning time to successful extubation
Time Frame: 28 days or extubation
28 days or extubation
ventilator weaning days
Time Frame: 28 days or extubation
28 days or extubation
total duration of ventilatory support
Time Frame: 28 days or extubation
28 days or extubation

Secondary Outcome Measures

Outcome Measure
Time Frame
reintubations within 48 hours
Time Frame: 48 hrs
48 hrs
sedation and analgesic requirements
Time Frame: 28 days or extubation
28 days or extubation
ICU and hospital length of stay
Time Frame: total time of ICU and hospital stay
total time of ICU and hospital stay
clinical staff time requirements
Time Frame: during active weaning period
during active weaning period

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2008

Primary Completion (Actual)

October 1, 2011

Study Completion (Actual)

October 1, 2011

Study Registration Dates

First Submitted

December 19, 2008

First Submitted That Met QC Criteria

December 22, 2008

First Posted (Estimate)

December 23, 2008

Study Record Updates

Last Update Posted (Estimate)

May 8, 2015

Last Update Submitted That Met QC Criteria

May 6, 2015

Last Verified

May 1, 2015

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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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