Mechanical Ventilation Discontinuation Practices (IOS)
2021年3月30日 更新者：Unity Health Toronto
Practice Pattern Variation in Discontinuing Mechanical Ventilation in Critically Ill Adults: An International Prospective Observational Study
Background: The requirement for ventilator support is a defining feature of critical illness. Weaning is the process during which the work of breathing is transferred from the ventilator back to the patient. Approximately 40% of the total time spent on ventilators is dedicated to weaning. The extent of practice variation in how this complex and expensive technology is discontinued from critically ill patients is unknown. Meanwhile, practice variation has been shown to adversely impact upon patient safety and clinical outcomes.
Purpose: To characterize practice pattern variation in weaning and the consequences of weaning variation by implementing an international, prospective observational study in Canada, the United States, the United Kingdom, Europe, India and Australia/New Zealand.
Primary Objectives: To describe
- weaning practice variation among regions in 5 domains (the use of daily screening, preferred methods of support used before initial discontinuation attempts, use of written protocols, preferred methods of evaluating spontaneous breathing, and sedation and mobilization practices).
- the assocation between selected discontinuation strategies and important clinical outcomes (length of stay, mortality, duration of ventilation).
Methods: The investigators propose to conduct a large scale, observational study involving critically ill adults requiring ventilator support for at least 24 hours to evaluate practices in discontinuing ventilators in 150 centres. The investigators will classify each new admission over the observation period according to the initial strategy that precipitated or facilitated ventilator discontinuation.
Relevance: This novel study will build collaborations with critical care investigators from around the world and industry
調査の概要
状態
完了
詳細な説明
Background: The requirement for mechanical ventilation is a defining feature of critical illness. Weaning is the process during which the work of breathing is transferred from the ventilator back to the patient. Approximately 40% of the total time spent on mechanical ventilation is dedicated to weaning. The extent and predictors of practice variation in how this complicated and expensive technology is discontinued from critically ill patients remains unknown. Meanwhile, practice pattern variability has been shown to adversely impact upon patient safety and important clinical outcomes.
Primary Objectives:
- To describe weaning practice variation with regard to the (i) use of daily screening, (ii) preferred methods of support used before initial discontinuation attempts, (iii) use of written weaning and spontaneous breathing trial (SBT) protocols, (iv) preferred methods used to conduct SBTs and (v) sedation and mobilization practices among geographic regions.
To describe the association between variation in weaning practices (direct extubation, tracheostomy, SBT conduct) and important clinical outcomes.
Secondary Objectives:
- To identify baseline and time-dependent factors associated with use of selected strategies.
- Among critically ill adults who undergo an initial SBT, the investigators will: a) investigate associations between SBT outcome (success/failure) and clinical outcomes, b) explore differences between critically ill patients who undergo an SBT early versus later in their intensive care unit (ICU) stay, and c) investigate the impact of different SBT techniques and humidification strategies on outcomes.
- To identify important predictors (patient, clinician, SBT, institutional and regional) of SBT outcome.
Study Design and Population: The investigators propose to conduct an international prospective observational study of mechanical ventilation discontinuation practices in 150 ICUs involving all newly admitted critically ill adults requiring invasive ventilation for at least 24 hours.
Study Centres: Interested centres have been identified through completion of an information card enclosed in a previously administered International Weaning Survey. The investigators will use a multimodal approach to identify participating centers in each of the 6 geographic regions (Canada, the United States, the United Kingdom, Europe, India and Australia/New Zealand).
Study Outcomes: The investigators will classify each new admission over the study week according to the initial strategy that precipitated or facilitated mechanical ventilation discontinuation into one of five categories: direct extubation, tracheostomy, SBT success, SBT failure or death. The investigator will describe the association between the use of alternative discontinuation strategies and important clinical outcomes (e.g., mortality, ICU and hospital stay, ICU readmission and reintubation rates).
Relevance: Through collaborations with industry partners and international colleagues we will implement this large scale observational study to quantify the existence and extent of practice variation in weaning. Information obtained from this study will inform the design of future studies aimed at reducing weaning practice variation and improving outcomes in critically ill patients receiving invasive mechanical ventilation
研究の種類
観察的
入学 (実際)
1868
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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Massachusetts
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Boston、Massachusetts、アメリカ、02111
- Tufts Medical Center
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Michigan
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Ann Arbor、Michigan、アメリカ、48109
- University of Michigan Health System
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-
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Ontario
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Hamilton、Ontario、カナダ
- St. Joseph's Hospital
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Hamilton、Ontario、カナダ、L8L2X2
- Hamilton Health Sciences Hamilton General Hospital
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Hamilton、Ontario、カナダ
- Juravinski Hospital Cancer Centre
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London、Ontario、カナダ、N6A 5A5
- London Health Sciences Centre - University Hospital Campus
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Ottawa、Ontario、カナダ
- Ottawa Civic Hospital
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Ottawa、Ontario、カナダ
- Ottawa General Hospital
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Toronto、Ontario、カナダ、M5B 1W8
- St. Michael's Hospital
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Toronto、Ontario、カナダ
- Mount Sinai Hospital
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Quebec
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Montréal、Quebec、カナダ、H2X 3J4
- Hôpital Saint-Luc
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Sherbrooke、Quebec、カナダ
- Université de Sherbrooke
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Sherbrooke、Quebec、カナダ
- Universite Hopitalier de Sherbrooke
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Trois-Rivières、Quebec、カナダ、G9A5C5
- Ciusss McQ
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
16年歳以上 (子、大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
サンプリング方法
非確率サンプル
調査対象母集団
We propose to conduct an International, Prospective Observational Study of Mechanical Ventilation Discontinuation Practices among critically ill adults who receive invasive mechanical ventilation for at least 24 (i.e., > or equal to 24) hours in approximately 150 international ICUs
説明
Inclusion Criteria:
- All newly admitted critically ill adults after study initiation at participating ICUs.
- Requiring invasive mechanical ventilation for at least 24 (i.e. > or equal to 24) hours
Exclusion Criteria:
- Transferred to a participating ICU without a clear time of intubation
- Tracheotomy/tracheostomy present at the time of ICU admission
- Already on ventilator settings compatible with a SBT [e.g., T-piece or Continuous Positive Airway Pressure < or =5 cm H2O (water) or Pressure Support < or = 8 cm H2O (with or without PEEP) or Automatic Tube Compensation (ATC) or equivalent] at the time of ICU admission
- Patient residing in ICU for > or = 24 hours at the time of the study activation (i.e., not a new admission from the time of study activation).
- Patient readmitted to this ICU during the study period (i.e., would constitute a second inclusion) unless they were ineligible during their first admission
- Patients participating in studies (e.g., randomized controlled trials) with explicit weaning protocols incorporated into the study design
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
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INITIAL SBT
Patients who underwent an Spontaneous Breathing Trial prior to extubation.
This cohort will be further subdivided into initial patients who initially pass an SBT successes and those who initially fail an SBT.
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DIRECT EXTUBATION
Patients that were directly extubated without conduct of a prior SBT or tracheostomy
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DIRECT TRACHEOSTOMY
Patients who underwent a direct tracheostomy without conduct of a prior SBT or extubation
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No attempt at mechanical ventilation discontinuation
Patients who died without conduct of a prior SBT, extubation or tracheostomy
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Practice variation among geographic regions in the use of daily screening to identify candidates to undergo an SBT
時間枠：Through study completion (approximately 4 years)
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Use of once daily screening in clinical practice
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Through study completion (approximately 4 years)
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Practice variation among geographic regions in the preferred methods of ventilator support used before initial discontinuation attempts
時間枠：Through study completion (approximately 4 years)
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Differences in ventilator modes (Pressure Support, Assist Control, other) prior to discontinuation attempts
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Through study completion (approximately 4 years)
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Practice variation among geographic regions in the use of written weaning and SBT protocols
時間枠：Through study completion (approximately 4 years)
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Use of written protocols to liberate patients from ventilators
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Through study completion (approximately 4 years)
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Practice variation among geographic regions in the methods used to conduct SBTs (and humidify oxygen)
時間枠：Through study completion (approximately 4 years)
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Use of different techniques to conduct SBTs (Pressure Support, T-piece, etc.)
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Through study completion (approximately 4 years)
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Practice variation among geographic regions in the sedation and mobilization practices during weaning
時間枠：Through study completion (approximately 4 years)
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Use of different levels of sedation (Sedation Agitation Scale) and levels of mobilization (active, passive, none)
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Through study completion (approximately 4 years)
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Association between variation in the weaning practices and total duration of ventilation.
時間枠：Through study completion (approximately 4 years)
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We will describe the association between variation in the weaning practices and the total duration of ventilation.
|
Through study completion (approximately 4 years)
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Association between variation in the weaning practices and ICU mortality
時間枠：Through study completion (approximately 4 years)
|
We will describe the association between variation in the weaning practices and ICU mortality.
|
Through study completion (approximately 4 years)
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Association between variation in the weaning practices and hospital mortality.
時間枠：Through study completion (approximately 4 years)
|
We will describe the association between variation in the weaning practices and hospital mortality.
|
Through study completion (approximately 4 years)
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Association between variation in the weaning practices and the proportion of patients off the ventilator at day 28.
時間枠：Through study completion (approximately 4 years)
|
We will describe the association between variation in the weaning practices and the proportion of patients off the ventilator at day 28.
|
Through study completion (approximately 4 years)
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Association between variation in the weaning practices and the proportion of patients out of the ICU at day 28.
時間枠：Through study completion (approximately 4 years)
|
We will describe the association between variation in the weaning practices and the proportion of patients out of the ICU at day 28.
|
Through study completion (approximately 4 years)
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Association between variation in the weaning practices and ICU LOS.
時間枠：Through study completion (approximately 4 years)
|
We will describe the association between variation in the weaning practices and ICU LOS (total and among survivors and non survivors).
|
Through study completion (approximately 4 years)
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Association between variation in the weaning practices and hospital LOS.
時間枠：Through study completion (approximately 4 years)
|
We will describe the association between variation in the weaning practices and hospital LOS (total and among survivors and non survivors).
|
Through study completion (approximately 4 years)
|
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Association between variation in the weaning practices and ICU readmission.
時間枠：Through study completion (approximately 4 years)
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We will describe the association between variation in the weaning practices and ICU readmission (during the current hospitalization).
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Through study completion (approximately 4 years)
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Association between variation in the weaning practices and reintubation.
時間枠：Through study completion (approximately 4 years)
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We will describe the association between variation in the weaning practices and reintubation (or repeat ventilation following disconnection in tracheostomized patients) within 48 hours of extubation.
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Through study completion (approximately 4 years)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Identify baseline characteristics and time-dependent factors associated with use of selected strategy (direct extubation, direct tracheostomy, Initial SBT) to discontinue mechanical ventilation
時間枠：Through study completion (approximately 4 years)
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We will use cox proportion hazards modelling to identify baseline characteristics and time-dependent factors (development of adult respiratory distress syndrome, heart failure, acute kidney injury requiring dialysis) associated with the use of selected discontinuation strategies (direct extubation, direct tracheostomy, Initial SBT)
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Through study completion (approximately 4 years)
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Association between initial SBT outcome (success/failure) and total duration of ventilation.
時間枠：Through study completion (approximately 4 years)
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Describe the associations between SBT outcome (success/failure) and the total duration of ventilation.
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Through study completion (approximately 4 years)
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Association between initial SBT outcome (success/failure) and ICU mortality.
時間枠：Through study completion (approximately 4 years)
|
Describe the associations between SBT outcome (success/failure) and ICU mortality.
|
Through study completion (approximately 4 years)
|
|
Association between initial SBT outcome (success/failure) and hospital mortality.
時間枠：Through study completion (approximately 4 years)
|
Describe the associations between SBT outcome (success/failure) and hospital mortality.
|
Through study completion (approximately 4 years)
|
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Association between initial SBT outcome (success/failure) and the proportion of patients off of the ventilator at day 28
時間枠：Through study completion (approximately 4 years)
|
Describe the associations between SBT outcome (success/failure) and the proportion of patients off the ventilator at day 28.
|
Through study completion (approximately 4 years)
|
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Association between initial SBT outcome (success/failure) and the proportion of patients out of the ICU at day 28.
時間枠：Through study completion (approximately 4 years)
|
Describe the associations between SBT outcome (success/failure) and the proportion of patients out of the ICU at day 28.
|
Through study completion (approximately 4 years)
|
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Association between initial SBT outcome (success/failure) and ICU LOS.
時間枠：Through study completion (approximately 4 years)
|
Describe the associations between SBT outcome (success/failure) and ICU LOS (total and among survivors and non survivors.
|
Through study completion (approximately 4 years)
|
|
Association between initial SBT outcome (success/failure) and hospital LOS.
時間枠：Through study completion (approximately 4 years)
|
Describe the associations between SBT outcome (success/failure) and hospital LOS (total and among survivors and non survivors.
|
Through study completion (approximately 4 years)
|
|
Association between initial SBT outcome (success/failure) and ICU readmission.
時間枠：Through study completion (approximately 4 years)
|
Association between initial SBT outcome (success/failure) and ICU readmission (during the current hospitalization).
|
Through study completion (approximately 4 years)
|
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Association between initial SBT outcome (success/failure) and reintubation.
時間枠：Through study completion (approximately 4 years)
|
Describe the associations between SBT outcome (success/failure) and reintubation (or repeat ventilation following disconnection in tracheostomized patients) within 48 hours of extubation c) Describe the association between different SBT techniques on clinical outcomes and d) Describe the association between use of selected humidification strategies and clinical outcomes. |
Through study completion (approximately 4 years)
|
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Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on the total duration of ventilation.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on the total duration of ventilation.
|
Through study completion (approximately 4 years)
|
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Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on ICU mortality.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on ICU mortality.
|
Through study completion (approximately 4 years)
|
|
Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on hospital mortality.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on hospital mortality.
|
Through study completion (approximately 4 years)
|
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Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on the proportion of patients off the ventilator at day 28.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on the proportion of patients off the ventilator at day 28.
|
Through study completion (approximately 4 years)
|
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Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on the proportion of patients out of the ICU at day 28.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on the proportion of patients out of the ICU at day 28.
|
Through study completion (approximately 4 years)
|
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Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on ICU LOS.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on ICU LOS (total and among survivors and non survivors).
|
Through study completion (approximately 4 years)
|
|
Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on hospital LOS.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on hospital LOS (total and among survivors and non survivors).
|
Through study completion (approximately 4 years)
|
|
Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on ICU readmission.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on ICU readmission (during the current hospitalization).
|
Through study completion (approximately 4 years)
|
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Differences in clinical outcomes between patients who undergo an SBT early versus later in their ICU stay on reintubation.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on reintubation (or repeat ventilation following disconnection in tracheostomized patients) within 48 hours of extubation.
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and total duration of ventilation.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on the total duration of ventilation.
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and ICU mortality.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on ICU mortality.
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and hospital mortality.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on hospital mortality.
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and the proportion of patients off the ventilator at day 28.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on the proportion of patients off the ventilator at day 28.
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and the proportion of patients out of the ICU at day 28.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on the proportion of patients out of the ICU at day 28.
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and ICU LOS.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on ICU LOS (total and among survivors and non survivors).
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and hospital LOS.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on hospital LOS (total and among survivors and non survivors).
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and ICU readmission.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on ICU readmission (during the current hospitalization).
|
Through study completion (approximately 4 years)
|
|
Association between different SBT techniques and reintubation.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different SBT technique (e.g., Pressure Support, T-piece) and the impact on reintubation (or repeat ventilation following disconnection in tracheostomized patients) within 48 hours of extubation
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and the total duration of ventilation.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on the total duration of ventilation.
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and ICU mortality.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on ICU mortality.
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and hospital mortality.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on hospital mortality.
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and the proportion of patients off the ventilator at day 28.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on the proportion of patients off the ventilator at day 28.
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and the proportion of patients out of the ICU at day 28.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on the proportion of patients out of the ICU at day 28.
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and ICU LOS.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on ICU LOS (total and among survivors and non survivors).
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and hospital LOS.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on hospital LOS (total and among survivors and non survivors).
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and ICU readmission.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on ICU readmission (during the current hospitalization).
|
Through study completion (approximately 4 years)
|
|
Association between use of selected humidification strategies and reintubation.
時間枠：Through study completion (approximately 4 years)
|
Associations between use of different humidification strategies (e.g., Heat and Moisture Exchanger, heated humidifier) and the impact on reintubation (or repeat ventilation following disconnection in tracheostomized patients) within 48 hours of extubation.
|
Through study completion (approximately 4 years)
|
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Predictors of initial SBT outcome.
時間枠：Through study completion (approximately 4 years)
|
Describe important predictors (patient, clinician, SBT, institutional and regional-related) of initial SBT outcome (SBT success and failure) using a single regression analysis.
One analysis will be conducted to describe significant predictors.
|
Through study completion (approximately 4 years)
|
協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
スポンサー
捜査官
- 主任研究者：Karen E.A. Burns, MD, FRCPC, MSc、St. Michael's Hospital, Li Ka Shing Knowledge Institute, University of Toronto
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Burns KEA, Rizvi L, Cook DJ, Lebovic G, Dodek P, Villar J, Slutsky AS, Jones A, Kapadia FN, Gattas DJ, Epstein SK, Pelosi P, Kefala K, Meade MO; Canadian Critical Care Trials Group. Ventilator Weaning and Discontinuation Practices for Critically Ill Patients. JAMA. 2021 Mar 23;325(12):1173-1184. doi: 10.1001/jama.2021.2384.
- Burns KEA, Rizvi L, Cook DJ, Dodek P, Slutsky AS, Jones A, Villar J, Kapadia FN, Gattas DJ, Epstein SK, Meade MO; Canadian Critical Care Trials Group. Variation in the practice of discontinuing mechanical ventilation in critically ill adults: study protocol for an international prospective observational study. BMJ Open. 2019 Sep 8;9(9):e031775. doi: 10.1136/bmjopen-2019-031775.
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2013年11月4日
一次修了 (実際)
2016年12月17日
研究の完了 (実際)
2016年12月17日
試験登録日
最初に提出
2019年5月3日
QC基準を満たした最初の提出物
2019年5月16日
最初の投稿 (実際)
2019年5月20日
学習記録の更新
投稿された最後の更新 (実際)
2021年4月2日
QC基準を満たした最後の更新が送信されました
2021年3月30日
最終確認日
2021年3月1日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。