Weaning From Prolonged Mechanical Ventilation
Acute Mechanical Ventilatory Failure
About this trial
This is an interventional treatment trial for Acute Mechanical Ventilatory Failure focused on measuring mechanical ventilation, weaning, pressure support, spontaneous breathing, Long-term acute care facility, mortality
Eligibility Criteria
Inclusion Criteria:
- Mechanical Ventilation for at least 21 days
Exclusion Criteria:
- Hypoxemia (oxygen saturation < 90% with fractional inspired O2 concentration > 0.40, and positive end-expiratory pressure > 5 cm H2O
- Hemodynamic instability (requiring intravenous vasoactive agents, such as dopamine > 5 mg/kg/min)
- Profound neurological deficits (large stroke)
- Documented bilateral phrenic nerve injury
- Previous admission to RML Hospital
- Life expectancy less than 3 months
Sites / Locations
- RML Specialty Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Pressure support
Spontaneous Breathing
Patients randomized to the pressure support arm will wean using pressure support ventilation. The level of pressure support will be decreased by 2 cm H2O every 6 hours. The maximum decrement in pressure support permitted in one day will be 6 cm H2O.
Patients randomized to spontaneous breathing arm will be disconnected from the ventilator and allowed to breathe spontaneously through the tracheostomy. Duration of the trial will be increased sequentially as tolerated.