A Cluster Randomized Trial to Improve Weaning and Extubation From Mechanical Ventilation in Community Hospitals

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Overview

Protocol directed weaning has been shown to reduce the duration of mechanical ventilation for patients admitted to the intensive care unit (ICU) of tertiary centres. However, this benefit has not previously been studied in a community hospital setting. We therefore sought to evaluate the impact of an evidence-based weaning guideline on the outcomes for patients receiving mechanical ventilation in the ICUs of community hospitals in a cluster randomized controlled trial involving 11 community hospitals.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Conditions

Respiration, Artificial

Interventions

Evidence based weaning protocolPROCEDURE

Eligibility

Sex: ALLMin age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients ventilated for more than 24 hours Exclusion Criteria: * patients less than 16 years of age patients who receive only non-invasive ventilation patients chronically ventilated at time of ICU admission patients who will not be candidates for weaning from ventilation at time of admission If withdrawl of life support is imminent at the point the patient has been ventilated for 24 hours

Locations (11)

William Osler Health Centre (Brampton)

Brampton, Ontario, Canada

Brant Community Health Systems

Brantford, Ontario, Canada

Joseph Brant Memorial Hospital

Burlington, Ontario, Canada

Outcomes

Primary Outcomes

ICU length of stay

Secondary Outcomes

duration of ventilation

length of hospital stay

complications (re-intubation within 48 hours, pneumonia within 48 hours)

ICU mortality

Hospital mortality

ICU readmissions

Qulaity of life

Data from ClinicalTrials.gov

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