Effect of Increased Muscular Work During Different Weaning Strategies in Critically Ill Patients

The recruitment status of this study is unknown because the information has not been verified recently.
Verified October 2007 by Università degli Studi dell'Insubria.
Recruitment status was  Recruiting
Sponsor:
Information provided by:
Università degli Studi dell'Insubria
ClinicalTrials.gov Identifier:
NCT00538746
First received: October 2, 2007
Last updated: NA
Last verified: October 2007
History: No changes posted
  Purpose

Most patients admitted to intensive care units require mechanical ventilation. Weaning from assisted/controlled ventilation begins when we recognize that the patient has recovered adeguately from acute respiratory failure.

If weaning is delayed, costs are increased, as are the risks of nosocomial pneumonia, cardiac-associated morbility, and death. On the other hand, weaning too soon often results in reintubation, which is associated with complications similar to those of prolonged ventilation.

The aim of this trial is to establish an evidence-based approach to weaning and to determine when a patient is ready to be weaned from mechanical ventilation, and what is the best weaning technique.


Condition Intervention
Acute Respiratory Failure
Device: BIPAP
Device: PSV
Device: PSV + CPAP

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment

Resource links provided by NLM:


Further study details as provided by Università degli Studi dell'Insubria:

Primary Outcome Measures:
  • 1. Days of intubation 2. Days of mechanical ventilation [ Time Frame: 28 days ]

Secondary Outcome Measures:
  • 1. The day of eventual tracheostomy 2. Organ Failure 3. The mortality at 28° day 4. Outcome at 6 months [ Time Frame: 1 year ]

Study Start Date: February 2005
Arms Assigned Interventions
Experimental: 1
BIPAP (Bilevel Positive Airway Pressure) targeted on: TV 6-8 ml/kg, total RR 10-30/min, PEEP and FiO2 regulated on Sat greater than 92% (with spontaneous RR between 20-40%)
Device: BIPAP
Experimental: 2
PSV (pressure support ventilation) targeted on: TV 6-8 ml/kg,total RR 10-30/min, PEEP and FiO2 regulated on Sat greater than 92, a minimum of 7 cmH2O of PS is tolerated.
Device: PSV
Experimental: 3
PSV+CPAP (continuous positive airway pressure) targeted on: PSV: TV 6-8 ml/kg,total RR 10-30/min, PEEP and FiO2 regulated on Sat greater than 92, a minimum of 7 cmH2O of PS is tolerated, CPAP (5-10 cmH2O) at least 2 hours a day. If during the CPAP periods at least 1 of the criteria T tube test failure occurs, the patients will come back immediately to PSV.
Device: PSV + CPAP

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Criteria

Inclusion Criteria:

  1. Age higher than 18 yrs
  2. PaO2/FiO2 greater or equal than 150 with PEEP equal or lower than 10, and minute ventilation lower than 15 l/min
  3. Temperature lower than 38,5°C
  4. Stable hemodynamics: HR 60-125 b/min, SBP 90-160 mmHg without or with dopamine lower than 10 gamma/Kg/min or dobutamine lower than 10 gamma/Kg/min, no acute arrythmias
  5. Hb higher than 8 g/dl
  6. GCS higher or equal than 9
  7. The attending physician has to agree that the patient is in stable conditions and ready to be weaned from the ventilator

Exclusion Criteria:

  1. presence of chronic neuromuscular diseases
  2. need of surgical intervention within the next 72 hours
  3. difficult tracheal intubation
  4. tracheostomized patients
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00538746

Contacts
Contact: Paolo Pelosi, Professor 0039-0332-278801 ppelosi@hotmail.com

Locations
Italy
Ospedale di Circolo e Fondazione Macchi Recruiting
Varese, Italy, 21100
Contact: Paolo Pelosi, Professor    0039-0332-278801    ppelosi@hotmail.com   
Principal Investigator: Paolo Pelosi, Professor         
Sponsors and Collaborators
Università degli Studi dell'Insubria
Investigators
Principal Investigator: Paolo Pelosi, Professor Universita' degli Studi dell'Insubria
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00538746     History of Changes
Other Study ID Numbers: 1500
Study First Received: October 2, 2007
Last Updated: October 2, 2007
Health Authority: Italy: Ethics Committee

Additional relevant MeSH terms:
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Lung Diseases
Respiration Disorders
Respiratory Tract Diseases

ClinicalTrials.gov processed this record on October 29, 2014