COMPLETED

Mechanical Ventilator Weaning in Chronically Ventilated Patients

Conditions

Mechanical Ventilation Complication prolonged mechanical ventilation ventilator weaning tracheostomy

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Mechanical ventilation is a commonly used life-saving hospital procedure for patients with severe breathing difficulty. Some patients have difficulty separating from the ventilator and need to be removed gradually. This process is called ventilator weaning. It is not known what is the best way to wean patients from the ventilator. In this study, the investigators will compare two commonly used ventilator weaning strategies and compare their success. One ventilator strategy, the Pressure Support Ventilation weaning (PSV), combines 12 hours ventilator weaning with 12 hours rest on the ventilator. This strategy is faster with an anticipated weaning in 2 weeks. The other strategy, the Therapist implemented Patient Specific weaning (TIPS), gradually lowers support and weans in 3 weeks. Patients admitted to Barlow Respiratory Hospital (BRH) for ventilator weaning will be asked to participate in this study within 72 hours of hospital admission. Participants will undergo a spontaneous breathing trial (SBT) to assess your ability to breathe while receiving minimal or no ventilator support. Patients who pass SBT will be eligible for cool aerosol trials (humidified, oxygenated air without positive pressure mechanical ventilation). Participants who fail SBT within 24 hours will be eligible for the study. Participants will be randomized to receive PSV or TIPS ventilator weaning. The investigators will collect clinical, laboratory and mechanical ventilator information throughout the study period. Ventilator weaning success will be compared at day 30. The study will not interfere with any components of clinical care but the study investigators will be allowed to change the ventilator weaning strategy from PSV to TIPS, if a participant is unable to tolerate PSV weaning.

Official Title

Mechanical Ventilator Weaning in Chronically Ventilated Patients

Quick Facts

Study Start:2023-09-01

Study Completion:2025-07-29

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:COMPLETED

Study ID

NCT06976554

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.

Ages Eligible for Study:Not specified

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:CHILD, ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
1. Patients requiring positive pressure mechanical ventilation for at least 21 days prior to BRH admission and 2. Have a secure tracheostomy.	1. Inability to obtain informed consent from patient or DPOA 2. Incarcerated patients 3. Patients with less than 3 months of life expectancy 4. Patients requiring vasopressor medication to stabilize blood pressure on admission 5. Systolic blood pressure less than 90mmHg on admission 6. Pulse less than 50 or greater than 130 beats per minute or change by more than 20 from baseline on admission 7. Respiratory rate greater than 35/min 8. Oxygen saturation less than 90% 9. PEEP\>5cmH2O 10. Lung tidal volume less than 250ml despite MV support 11. At least one previous admission to BRH with unsuccessful ventilator liberation attempt 12. Length of Stay (LOS) at BRH less than 24hours 13. Patients pass spontaneous breathing trial (SBT) on D1 and eligible for cool aerosol, except if they fail SBT on D2 and require continued MV

Inclusion Criteria

Exclusion Criteria

1. Patients requiring positive pressure mechanical ventilation for at least 21 days prior to BRH admission and
2. Have a secure tracheostomy.

1. Inability to obtain informed consent from patient or DPOA
2. Incarcerated patients
3. Patients with less than 3 months of life expectancy
4. Patients requiring vasopressor medication to stabilize blood pressure on admission
5. Systolic blood pressure less than 90mmHg on admission
6. Pulse less than 50 or greater than 130 beats per minute or change by more than 20 from baseline on admission
7. Respiratory rate greater than 35/min
8. Oxygen saturation less than 90%
9. PEEP\>5cmH2O
10. Lung tidal volume less than 250ml despite MV support
11. At least one previous admission to BRH with unsuccessful ventilator liberation attempt
12. Length of Stay (LOS) at BRH less than 24hours
13. Patients pass spontaneous breathing trial (SBT) on D1 and eligible for cool aerosol, except if they fail SBT on D2 and require continued MV

Contacts and Locations

Study Locations (Sites)

Barlow Respiratory Hospital

Los Angeles, California, 90026

United States

Collaborators and Investigators

Sponsor: University of California, Los Angeles

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 Registration Dates

Study Start Date2023-09-01

Study Completion Date2025-07-29

Study Record Updates

Study Start Date2023-09-01

Study Completion Date2025-07-29

Terms related to this study

Keywords Provided by Researchers

prolonged mechanical ventilation
ventilator weaning
tracheostomy

Additional Relevant MeSH Terms

Mechanical Ventilation Complication