Weaning children from the breathing machine in the children’s intensive care unit

Conditions

Acute respiratory failure Respiratory

Rebecca Mitting, Clíona McDowell, Bronagh Blackwood, Samiran Ray

Pediatric Critical Care Medicine2025-01-238 citations

Delivery of a novel intervention to facilitate liberation from mechanical ventilation in paediatric intensive care: A process evaluation

Joanne Jordan, Lyvonne N. Tume, Mike Clarke, Daniel F. McAuley, Clíona McDowell et al. (10 authors)

PLoS ONE2023-11-271 citations

10.1371/journal.pone.0293063

Co-ordinated multidisciplinary intervention to reduce time to successful extubation for children on mechanical ventilation: the SANDWICH cluster stepped-wedge RCT

Bronagh Blackwood, Kevin P Morris, Joanne Jordan, Lisa McIlmurray, Ashley Agus et al. (19 authors)

Health Technology Assessment2022-03-014 citations

10.3310/tcfx3817

Effect of a Sedation and Ventilator Liberation Protocol vs Usual Care on Duration of Invasive Mechanical Ventilation in Pediatric Intensive Care Units

Bronagh Blackwood, Lyvonne N. Tume, Kevin Morris, Mike Clarke, Clíona McDowell et al. (88 authors)

JAMA2021-08-0388 citations

10.1001/jama.2021.10296

Sedation AND Weaning In Children (SANDWICH): protocol for a cluster randomised stepped wedge trial

Bronagh Blackwood, Ashley Agus, Roisin Boyle, Mike Clarke, Karla Hemming et al. (16 authors)

BMJ Open2019-11-0118 citations

10.1136/bmjopen-2019-031630

Interventions

This study will be conducted in up to 18 Paediatric Intensive Care Units (PICUs) across the UK. Each PICU will be considered a 'cluster' in this trial. All clusters will open and start the trial at th

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: All invasively mechanically ventilated children < 16 years old

Exclusion criteria

Exclusion criteria: 1. Children who would not reach the primary endpoint Added 15/05/2019: 2. Children who are pregnant, as documented in their medical notes

Design outcomes

Primary

Measure	Time frame
Duration of Invasive Mechanical Ventilation measured in hours through review of patient Intensive care charts from initiation of invasive ventilation until successful extubation (success defined as still breathing spontaneously 48 hours following extubation); Timepoint(s): 48 hours	—

Secondary

Measure	Time frame
1. Incidence of successful extubation is measured through review of patient intensive care charts at 48 hours following extubation 2. Number of unplanned extubations is measured through review of patient intensive care charts up to 90 days or PICU discharge 3. Number of reintubations is measured through review of patient intensive care charts up to 90 days or PICU discharge 4. Total duration of Invasive Mechanical Ventilation in hours through review of patient intensive care charts up to 90 days or discharge 5. Incidence and duration in minutes of post extubation use of non-invasive ventilation is measured through review of patient intensive care charts up to 90 days or PICU discharge 6. Incidence of tracheostomy insertion is measured through review of patient intensive care charts at 90 days or PICU discharge 7. Incidence of post-extubation Stridor is measured through review of patient intensive care charts at 90 days or PICU discharge 8. Incidence of any adverse events is measured through review of patient notes at 90 days or PICU discharge 9. PICU length of stay is measured in days through review of patient notes at PICU discharge 10. Hospital length of stay discharge is measured in days through review of patients notes at hospital discharge 11. Incidence of mortality in ICU is measured through review of the PICAnet data set at PICU discharge 12. Incidence of mortality in hospital is measured through review of patients notes at hospital discharge 13. Cost per complication avoided is measured through review of patients notes and the PICAnet dataset at 28 days	—

Measure

Time frame

1. Incidence of successful extubation is measured through review of patient intensive care charts at 48 hours following extubation 2. Number of unplanned extubations is measured through review of patient intensive care charts up to 90 days or PICU discharge 3. Number of reintubations is measured through review of patient intensive care charts up to 90 days or PICU discharge 4. Total duration of Invasive Mechanical Ventilation in hours through review of patient intensive care charts up to 90 days or discharge 5. Incidence and duration in minutes of post extubation use of non-invasive ventilation is measured through review of patient intensive care charts up to 90 days or PICU discharge 6. Incidence of tracheostomy insertion is measured through review of patient intensive care charts at 90 days or PICU discharge 7. Incidence of post-extubation Stridor is measured through review of patient intensive care charts at 90 days or PICU discharge 8. Incidence of any adverse events is measured through review of patient notes at 90 days or PICU discharge 9. PICU length of stay is measured in days through review of patient notes at PICU discharge 10. Hospital length of stay discharge is measured in days through review of patients notes at hospital discharge 11. Incidence of mortality in ICU is measured through review of the PICAnet data set at PICU discharge 12. Incidence of mortality in hospital is measured through review of patients notes at hospital discharge 13. Cost per complication avoided is measured through review of patients notes and the PICAnet dataset at 28 days

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Countries

England, Northern Ireland, United Kingdom, Wales

Contacts

Public ContactRoisin Boyle

SANDWICH@nictu.hscni.net+44 (0)28 90 635794

Outcome results

None listed