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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05114551
Other study ID # I -Swear (RNI 2021 AUDARD)
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date September 28, 2021
Est. completion date September 28, 2023

Study information

Verified date January 2023
Source University Hospital, Clermont-Ferrand
Contact Lise Laclautre
Phone +33 4 73 754963
Email promo_interne_drci@chu-clermontferrand.fr
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Observational study in two medical-surgical intensive care units of the Clermont-Ferrand University Hospital to develop a composite score for prediction of 72h-extubation failure in patients at risk of extubation failure.


Description:

In our intensive care units, when a patient does not have risk factors for extubation failure, SBT (Spontaneous Breathing Trial) in PSV (Pressure Support Ventilation) is usually performed first as recommended. If patient fails the first SBT in PSV or extubation, weaning is considered difficult (WIND study group AJRCCM 2017). In this case, the service protocol provides a T-piece SBT for the following SBT. In addition, this same protocol proposes to perform T-piece SBT from the first weaning event in patients with risk factors for WiPO (Weaning-induced Pulmonary Oedema), defined as obesity (BMI >30 kg/m2), COPD (Chronic Obstructive Pulmonary Disease) (suspected or known), or heart disease (structural [hypertrophic, dilated, valvular], functional [diastolic or systolic dysfunction], ischemic, or dysrhythmic). Our study population concerns patients for whom a T-piece trial is performed according to the service protocol. A patient is potentially includible in the study if he has been under mechanical ventilation for at least 48h and if he presents criteria of weanability with a planned T-piece SBT. As long as the inclusion and non-inclusion criteria are respected (see inclusion/non-inclusion criteria), clinical, biological and ultrasound data will be collected before and at the end of the ventilatory weaning test. If the patient fails the weaning test and/or is not extubated following the test, data from each new T-piece SBT will be collected within 7 days of inclusion. The global management of the patient, before, during and after the inclusion of the patient in the study is the one usually practiced in our intensive care units, based on the national and international recommendations as well as the literature exposed in the protocol. During the patient's stay in the ICU, data from the medical record will be collected (demographic, clinical, treatment, vital status,...). A follow-up at D7, D28 and D90 will be performed.


Recruitment information / eligibility

Status Recruiting
Enrollment 300
Est. completion date September 28, 2023
Est. primary completion date September 28, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Age > 18 years - Invasive mechanical ventilation for at least 48 hours - Criteria for ventilatory weaning are present - T-piece spontaneous breathing trial planned - Patients with a social security program Exclusion Criteria: - Patients already included in this study during the same stay in intensive care - Resuscitation neuromyopathy defined by an MRC (Medical Research Council) score < 48/60 - Surgery planned within 72 hours - Prolonged ventilatory weaning (>7 days after the first SBT) - Patients with tracheostomy - Patients with non-reintubation decision or terminal extubation - Brain damaged patients - Patients with ECMO/ECLS - Tetraplegic or paraplegic patients with lesion level higher than T8 - Nasotracheal intubated patients - Pregnant or breastfeeding women - Refusal to participate in the study (refusal by patient or family member/trusted person). - Patients under guardianship

Study Design


Locations

Country Name City State
France CHU Clermont-Ferrand

Sponsors (1)

Lead Sponsor Collaborator
University Hospital, Clermont-Ferrand

Country where clinical trial is conducted

France, 

Outcome

Type Measure Description Time frame Safety issue
Primary The primary outcome measure is extubation failure, defined as the need for reintubation within 72 hours of extubation. 72 hours
Secondary Mortality at day 7, 28 and 90 90 days
Secondary Length of stay in intensive care 90 days
Secondary Number of days without mechanical ventilation from study inclusion to day 28 28 days
Secondary Time frame and reasons for reintubation in case of failed extubation. 28 days
Secondary Use of non-invasive post-extubation ventilation 7 days
Secondary Use of High Flow Nasal Oxygenation post-extubation 7 days
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