To determine whether ASV with a proactive approach results in shorter weaning time as compared to ASV alone.
ID
Source
Brief title
Condition
- Therapeutic procedures and supportive care NEC
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Duration of mechanical ventilation.
Secondary outcome
Length of stay in the ICU.
Number of re-intubations
Number of ABG*analysis.
Background summary
In the ICU, patients after coronary artery bypass grafting (CABG) wean from the
ventilator by using adaptive support ventilation (ASV). In the first hours
mechanical ventilation is fully mandatory, and the ventilator deliveres all
support. If the patient wakes up from anesthesia the ventilator automatically
switches to supportive ventilation, after which support is gradually but
automatically reduced. This form of weaning is the standard strategy in our
department. However, we consider time till extubation in these patients still
too long. In the study as proposed we compare time till extubation with
standard ASV, with ASV during which IC-nurse/physicians reduce ventilatory
support more actively, depending on patient's situation. Both forms of weaning
are presently used among other ICUs among the Netheralnds and beyond. From the
literature and from personal experiences we know both methods are safe.
Study objective
To determine whether ASV with a proactive approach results in shorter weaning
time as compared to ASV alone.
Study design
Randomized controlled trial.
Intervention
Two waning strategies are compared - in the control group patients are weaned
from the ventilator with ASV; in the study group patients are ventilated with
ASV too, but IC-nurses/physicians actively lower support according to a
pro-active protocol.
Study burden and risks
The burden and risks for the patients are minimal. Apart from the time
consumed for informed consent, in fact there is no burden. No extra blood will
be drawn. Experience in our own and other centers have shown that weaning with
both strategies is feasable and safe
meiberdreef 9
1017 HX
Nederland
meiberdreef 9
1017 HX
Nederland
Listed location countries
Age
Inclusion criteria
1. Planned and uneventful CABG.
2. Following receipt of verbal and written information about the trial, the patient must provide signed and dated informed consent before any trial related activity is carried out
Exclusion criteria
1. History of any pulmonary disease.
2. History of any previous pulmonary surgery.
3. Valve surgery.
4. Arrival at the ICU with intra*aortic balloon pump, or inotropes at a more then usual rate (maximum dosages in ml per hour: dopamine [4], norepinephrine [4], dobutamin [4] or epinephrine [any rate]).
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL16393.018.07 |
| Other | volgt |