Acute Respiratory Distress Syndrome, Hypoxic Respiratory Failure, Mechanical Ventilation
Conditions
Keywords
ARDS, ALI, mechanical ventilation
Brief summary
Today, the electronic medical record, microprocessor mechanical ventilators, and physiologic monitoring are under-utilized when translating research into decision support. Current medical informatic capabilities can be leveraged to calculate trends in measured parameters to initiate a paradigm shift in critical care from reaction-based treatment to proactive and plausibly preventative care. Therefore, the purpose of this study is to develop baseline understanding of our practice and how data collection utilizing a newly implemented system called T3. We would like to retrospectively review mechanically ventilated patients in which we have collected continuous data to test a newly developed analytic platform. Additionally we would like to compare these results to our standards of practice established by clinical practice guidelines.
Interventions
None listed
Sponsors
Boston Children's Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Days to 35 Years
Healthy volunteers
No
Inclusion criteria
* Patient selection will be determined by available data collected in the T3 system. We estimate 50 patients in which mechanical ventilator data has been collected utilizing the limited intellibridge modules (4 systems currently available to collect ventilator data).
Exclusion criteria
* Patient not connected to T3 data collection system.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Successful Extubation | Within 24 hours of extubation | Successful extubation without the use of noninvasive ventilation or requiring reintubation |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Patient Categorization We retrospectively categorized the ventilation and oxygenation statuses of patients within our PICU utilizing 15 rules based algorithms. Targets were predetermined based on generally accepted practices. All patient categories were calculated and presented as a percent score (0-100%) of acceptable ventilation, acceptable oxygenation, barotrauma free and volutrauma free states. | 222 |
| Total | 222 |
Baseline characteristics
| Characteristic | Patient Categorization |
|---|---|
| Age, Continuous | 3 years |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 9 Participants |
| Race (NIH/OMB) Black or African American | 17 Participants |
| Race (NIH/OMB) More than one race | 33 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 42 Participants |
| Race (NIH/OMB) White | 120 Participants |
| Region of Enrollment United States | 222 participants |
| Sex: Female, Male Female | 82 Participants |
| Sex: Female, Male Male | 140 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 9 / 104 | 20 / 222 |
| other Total, other adverse events | 0 / 104 | 0 / 222 |
| serious Total, serious adverse events | 0 / 104 | 0 / 222 |
Outcome results
Primary
Successful Extubation
Successful extubation without the use of noninvasive ventilation or requiring reintubation
Time frame: Within 24 hours of extubation
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Device Utlization Following Extubation | Successful Extubation | 58 Participants |
| Pulmonary Mechanics | Successful Extubation | 222 Participants |