Chronic Respiratory Failure Clinical Trial
Official title:
Randomized Prospective Multicenter Study of Non Invasive Ventilation Assessment for Weaning From Mechanical Ventilation in Patients With Chronic Respiratory Failure. NIV and Weaning (VENISE)Trial.
The clinical efficacy of noninvasive ventilation (NIV) has now been demonstrated in the
management of acute-on-chronic respiratory failure (ACRF) of various etiologies.
Endotracheal mechanical ventilation (ETMV) can lead to numerous complications and weaning
difficulties increasing the risk of prolonged ETMV, morbidity and mortality as well as
excess cost of intensive care. Therefore, it could be interesting to use NIV for delivering
effective ventilatory support and reduce the length of ETMV in ACRF patients still not
capable to maintain spontaneous breathing. From the interesting but discordant results of
two recent randomised controlled trial, a working group from the Société de Réanimation de
Langue Française (SRLF) decided to perform a new prospective randomised controlled and
multicenter trial. The aim of the study is to assess the usefulness of NIV as an extubation
and weaning technique in ventilated ACRF patients. The methodology used compares three
weaning strategies in parallel in ACRF patients considered difficult to wean : invasive
conventional weaning (group A), extubation relayed by nasal oxygentherapy (group B), and
extubation relayed by NIV (group C). Based on the main end-point defined as the weaning
success/failure rate, 208 patients from17 investigator centers are planned to be included.
Results of the study will also allow to assess the respective impact of the three weaning
strategies on the length of ETMV and weaning, the mechanical ventilation-related morbidity,
the patients lengths of stay and mortality.
Results of the VENISE trial should permit to improve the management of the difficult to wean
ACRF patients and thus to contribute to more define the place of NIV among the weaning and
prevention of re-intubation strategies in these patients.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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