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Liberation From Mechanical Ventilation Using Extubation Advisor Decision Support

RecruitingNAAges 18 Years - anyAllOttawa Hospital Research Institute
NCT05506904 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Timely and safe extubation in critically ill patients is vitally important as prolonged mechanical ventilation and failed attempts at extubation are associated with increased morbidity, mortality, costs, intensive care unit (ICU) stays, and a risk for aerosolization of COVID-19 to health care providers. A Spontaneous Breathing Trial (SBT) is the current standard of care to assess a patient's readiness for extubation. However, SBTs are performed in various ways and have poor ability to predict successful extubation on their own. There is an urgent need to improve and standardize extubation decision-making. In a prior multicenter study, the investigators showed that decreased respiratory rate variability during SBTs predicted extubation failure better than other predictive indices. The Extubation Advisor (EA) tool combines clinician's assessments of extubation readiness with predictive an

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📋 Eligibility rules (as published)
Inclusion Criteria: * Critically ill adults (age≥18) * Invasive ventilation for \>48 hours * Who are expected to undergo an initial SBT within the next 48 hours with a view to extubation as per treating MDs. As per the FAST trial, an SBT will be defined as a focused assessment on low ventilator settings \[T-piece, continuous positive airway pressure (CPAP), or PS \< 8 cm H2O regardless of positive end-expiratory pressure (PEEP) Exclusion Criteria: * Suffer from known or suspected peripheral severe myopathy or neuropathy, or limb weakness or paralysis or central (e.g., post arrest, large intracranial stroke or bleed) injury or Glasgow Coma Scale (GCS) \< 6 * Do not wish to be re-intubated as part of their treatment goals * Were previously extubated during the same ICU admission * Have undergone 1 or more SBTs where the SBT was clearly documented in the chart and/or the PS was reduced to the SBT level of 8 or less during the 24 hour period prior to randomization * Already have a tracheostomy * Are moribund or expected to die.
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What it tests

  • Extubation Advisor
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Where

12 sites
Royal Alexandra Hospital
Edmonton, Canada
St. Boniface Hospital
Winnipeg, Canada
Health Sciences Centre Winnipeg
Winnipeg, Canada
Kingston Health Sciences Centre
Kingston, Canada
The Ottawa Hospital
Ottawa, Canada
Queensway Carleton Hospital
Ottawa, Canada
Sunnybrook Health Sciences Centre
Toronto, Canada
Unity Health Toronto - St. Michael's Hospital
Toronto, Canada

…and 4 more on ClinicalTrials.gov.

🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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