Respiration, Artificial
Conditions
Keywords
Mechanical Ventilator, Ventilator Weaning, Spontaneous Breath Test, Predictive Index
Brief summary
Mechanical ventilation (MV) is an essential therapy for patients with acute respiratory failure. The ventilatory weaning process should be started when the precipitating causes of the use of the ventilatory prosthesis are resolved. Inappropriately slow weaning exposes the patient to unnecessary discomfort, increases the risk of complications and increases the cost of hospital treatment. In this sense, indices that can predict successful weaning are of great value.
Detailed description
Mechanical ventilation (MV) is an essential therapy for patients with acute respiratory failure. The ventilatory weaning process should be started when the precipitating causes of the use of the ventilatory prosthesis are resolved. Inappropriately slow weaning exposes the patient to unnecessary discomfort, increases the risk of complications and increases the cost of hospital treatment. In this sense, indices that can predict successful weaning are of great value. Our study aimed to evaluate the performance of a new ventilatory weaning index, the timed inspiratory effort index (TIE index), as a weaning predictor in comparison with the traditionally used spontaneous breathing test (SBT). The study is a randomized controlled trial of a cohort of mechanically ventilated patients over 24 hours admitted to the ICU of Hospital e Clínica São Gonçalo (HCSG), located in the city of São Gonçalo, State of Rio de Janeiro, Brazil. The TIE index is calculated as the ratio of the maximum inspiratory pressure developed in the last 30 seconds of a 60 second period of unidirectional airway occlusion by the time required to reach this value.
Interventions
DEVICETimed Inspiratory Effort (TIE index)
Conventional clinical treatment and using the Timed Inspiratory Effort (TIE index), which guided the decision to ventilate weaning and extubation.
Sponsors
Universidade Federal Fluminense
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
The secret will be kept by the data collecting investigators and will only be revealed at the end of the data analysis.
Intervention model description
Randomized controlled study
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
Inclusion and
Exclusion criteria
Our study included patients over 18 years old, under mechanical ventilation, who remained for more than 24 hours of invasive ventilatory assistance and who were able to start the process of weaning.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sucessful weaning | Two years | Compare the timed inspiratory effort index parameter TIE as an indicator of weaning compared to the spontaneous breathing test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of the length of stay in the ICU | Two years | Compare the length of stay in the ICU between extubation, discharge or death counted from extubation among patients who used the TIE or SBT index in T piece. |
| Frequency of failure at weaning | Two years | Compare the frequency of failure at weaning when using the TIE index or the T-piece TRE as a criterion for extubation. |
| Counting of the number of tests needed until extubation | Two years | Evaluate the number of tests required until the decision favorable to extubation was made in both groups. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Mortality rate | Two years | Compare the ICU mortality among patients using the TIE or TRE method in T piece |
Countries
Brazil
Outcome results
None listed