Acute Mechanical Ventilatory Failure Clinical Trial
Official title:
Weaning From Prolonged Mechanical Ventilation
Patients requiring the use of artificial ventilation (also called mechanical ventilation) for more than 21 days account for more than 37% of all ICU costs. As such, these patients are now transferred to centers that specialize in weaning patients from the respirator; these units are referred to as long-term acute care (LTAC) facilities. Despite the increase of LTAC facilities, research on the fastest method for disconnecting the patient from the respirator is lacking. In addition, little information is available regarding the long-term survival and quality of life after a prolonged course of artificial ventilation. The purpose of this study is to determine the fastest method for disconnecting the patient from the respirator at a LTAC facility and its effect on long-term survival and quality of life.
Patients requiring prolonged mechanical ventilation (defined as more than 21 days) account
for more than 37% of all ICU costs. As such, these patients are now transferred to centers
that specialize in weaning from mechanical ventilation, so called long-term acute care
(LTAC) facilities. Despite the proliferation of LTAC facilities, research on methods for
expediting weaning is lacking. In addition, little information is available regarding
long-term survival and patient's perception of quality of life after a prolonged course of
mechanical ventilation.
In patients receiving mechanical ventilation in an ICU, randomized trials have revealed that
ventilator duration was significantly influenced by weaning methods. The two most common
weaning methods are pressure support and spontaneous breathing trials. Unlike the ICU, the
relative efficacy of these two techniques in weaning patients requiring prolonged
ventilation at a LTAC facility is largely unknown. The aim of this proposal is to determine
whether the length of time required for weaning from prolonged ventilation differs with
pressure support versus spontaneous breathing trials. The second aim is to determine the
long-term impact of prolonged ventilation on survival, functional status and quality of
life.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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