Clinical Trials Logo

Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05134467
Other study ID # SMC 2017-08-141-009
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date November 1, 2017
Est. completion date September 30, 2029

Study information

Verified date November 2021
Source Samsung Medical Center
Contact Kyeongman Jeon
Phone 82-2-3410-2423
Email kjeon@skku.edu
Is FDA regulated No
Health authority
Study type Observational [Patient Registry]

Clinical Trial Summary

This is a prospective, single-center, observational study to describe characteristics of weaning process and factors associated with duration of weaning and its outcomes in all consecutive adult (aged 19 years and older) patients receiving mechanical ventilation for at least two calendar days in medical intensive care units since November 2017. Details of the patients' weaning process and spontaneous breathing trial (SBT) in addition to clinical, laboratory, and outcome data will be collected in a specified format on the day of the assessment by respiratory care practitioners.


Description:

Study design and objectives: This is a prospective, single-center, observational study to address key issues relating to weaning from mechanical ventilation (MV) in medical intensive care units. This study aims to describe characteristics of weaning process and factors associated with duration of weaning and its outcomes. Inclusion criteria: All consecutive adult (aged 19 years and older) patients receiving MV for at least two calendar days in medical intensive care units since November 2017 will be screened daily. Exclusion criteria: None Protocol based weaning process: Every morning, respiratory care practitioners assess a patient's readiness to be weaned from MV in all patients who received MV for more than 24 h. First, the patient's condition, including improvement of the underlying cause of respiratory failure, clinical stability, and adequacy of pulmonary function and oxygenation are comprehensively evaluated. If the patient fulfill all of the criteria of readiness for weaning trials, SBT is conducted according to the protocol to assess the ability of the patient for spontaneous breathing; if the patient does not fulfill the criteria, no further weaning process is performed on that day. Our hospital performed the T-piece trial, in which supplemental oxygen was provided through a T-piece connected to an endotracheal tube or tracheostomy tube, on all patients until July 2019. From July 2019, SBT has been performed with inspiratory pressure augmentation (the ventilator is set with a pressure support of 8 cmH2O and zero-positive end-expiratory pressure) for patients who received MV through an endotracheal tube according to the revised weaning protocol. Tolerance for SBT is evaluated for 30 min on the first attempt and for 2 h after the second attempt, regardless of the method used. However, if a sign of SBT failure is identified even before the target duration, the trial is immediately stopped. When the patient satisfies all the criteria for successful SBT, extubation is performed immediately, and supplemental oxygen is provided by a high-flow nasal cannula for at least 24 h in patients with an endotracheal tube; administration of supplemental oxygen is continued through a T-piece system in patients with tracheostomy. Decisions about when and how to perform a tracheostomy are left to the discretion of the clinicians and are not guided by a prescribed algorithm. Data collection and clinical outcomes: Clinical, laboratory, and outcome data will be prospectively collected by a trained study coordinator. The demographics of the patients and major cause of intubation will be evaluated and recorded by the physicians on the day of MV support initiation. Details of the patients' weaning readiness and SBT will be recorded in a specified format on the day of the assessment by respiratory care practitioners. The values of the MV setting and respiratory parameters are synchronized to the hospital electronic medical chart and recorded every hour, and we will collect the values at 8 am on the day of the first SBT. Clinical outcomes will be assessed by the successful weaning defined according to Weaning Outcome according to a New Definition (WIND) study and WIND classification of weaning. Ethical Approval and Patient Consent: The Institutional Review Board of Samsung Medical Center approved this study and waived the requirement for informed consent, because this study is pure observation and data collection program that involves no more than minimal risk, the data collected are part of routine clinical care that would not adversely affect rights and welfare of subject, and the data will be anonymized.


Recruitment information / eligibility

Status Recruiting
Enrollment 1000
Est. completion date September 30, 2029
Est. primary completion date September 30, 2029
Accepts healthy volunteers No
Gender All
Age group 19 Years to 99 Years
Eligibility Inclusion Criteria: - All consecutive adult patients receiving mechanical ventilation for at least two calendar days in medical intensive care units Exclusion Criteria: - None

Study Design


Related Conditions & MeSH terms


Locations

Country Name City State
Korea, Republic of Samsung Medical Center Seoul

Sponsors (1)

Lead Sponsor Collaborator
Samsung Medical Center

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type Measure Description Time frame Safety issue
Primary Successful weaning Extubation without death or reintubation within the next 7 days of spontaneous breathing trial or discharge from intensive care unit without invasive mechanical ventilation (MV) within 7 days, whichever comes first for intubated patients and as spontaneous ventilation through tracheostomy without any MV during 7 consecutive days or discharged with spontaneous breathing, whichever comes first for patients with tracheostomy after the first separation attempt 6 months from MV
Primary Weaning outcomes by the Weaning Outcome according to a New Definition (WIND) classification Group 1 (short weaning), the first attempt result in the termination of the weaning process within 1 day
Group 2 (difficult weaning), the weaning process is completed after more than 1 day but in less than 1 week after the first separation attempt
Group 3 (prolonged weaning), the weaning process is still not terminated 7 days after the first separation attempt.
6 months from MV
See also
  Status Clinical Trial Phase
Completed NCT03909854 - Pragmatic Investigation of Volume Targeted Ventilation-1 N/A
Completed NCT05690867 - Pressure Controlled Ventilation Versus Volume Controlled Ventilation in Upper Abdominal Surgery N/A
Enrolling by invitation NCT06151886 - Life-dependent Home Mechanical Ventilation
Not yet recruiting NCT04229810 - Individualized Perioperative Open Lung Ventilatory Approach in Emergency Abdominal Laparotomy. A Prospective Multicenter Randomized Controlled Trial. N/A
Recruiting NCT06051188 - FCV vs PCV in Moderate to Severe ARDS N/A
Completed NCT04497090 - Adaptive Non-invasive Ventilation to Abolish Tidal Flow Limitation N/A
Recruiting NCT06142474 - SGLT2 Inhibitors in Patients With ADHF During Ventilator Weaning Phase 3
Completed NCT04581642 - Nociception-Level (NOL) for the Assessment of Pain in Patient Unable to Self-Report
Recruiting NCT05812365 - Best End-Expiratory and Driving-pressure for Individualized Flow Controlled Ventilation in Patients With COPD
Recruiting NCT04376307 - Minimal Flow Application in One Lung Ventilation N/A
Recruiting NCT06178510 - I-ASV in Cardiac Surgery N/A
Recruiting NCT04484727 - "Lung Barometric Measurements in Normal And in Respiratory Distressed Lungs"
Completed NCT03411239 - Airway Pressure Changes Using Esophageal Balloon Catheter (OBC) in Laparoscopic Surgery N/A
Recruiting NCT05116839 - Pressure Support Ventilation Versus Continuous Positive Air Way Pressure (CPAP) Using I Gelin Adult Patients, N/A
Recruiting NCT03420417 - Respiratory Mechanics in Intensive Care Patients N/A
Completed NCT04258202 - Ventilator-driven Alveolar Recruitment Maneuver N/A
Recruiting NCT04307459 - Acute Respiratory Failure and COVID-19 in Real Life
Not yet recruiting NCT05726578 - Integrated Echocardiography and Chest Ultrasound Assessment of Lung Recruitment in Preterm Infants N/A
Completed NCT03558620 - Effect of an Endoscopic Bite Block on Mask Ventilation N/A
Completed NCT03226925 - Mechanically-assisted Ventilation in the Treatment of Moving Tumours With Photon and Proton Therapies N/A