Improving extubation decisions for critically ill patients

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This trial aims to enhance the decision-making process for extubation in critically ill patients using the Extubation Advisor (EA) tool. The EA combines clinician assessments with predictive analytics to better determine a patient's readiness for extubation, addressing the limitations of current Spontaneous Breathing Trials (SBTs). The study will assess the feasibility of implementing this decision-support tool in intensive care units to improve patient outcomes and reduce the risks associated with prolonged mechanical ventilation. By standardizing extubation decision-making, the trial seeks to minimize complications and improve overall care for patients requiring invasive ventilation.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Critically ill adults (age≥18)
* Invasive ventilation for \>48 hours
* Who are expected to undergo an initial SBT within the next 48 hours with a view to extubation as per treating MDs. As per the FAST trial, an SBT will be defined as a focused assessment on low ventilator settings \[T-piece, continuous positive airway pressure (CPAP), or PS \< 8 cm H2O regardless of positive end-expiratory pressure (PEEP)

Exclusion Criteria:

* Suffer from known or suspected peripheral severe myopathy or neuropathy, or limb weakness or paralysis or central (e.g., post arrest, large intracranial stroke or bleed) injury or Glasgow Coma Scale (GCS) \< 6
* Do not wish to be re-intubated as part of their treatment goals
* Were previously extubated during the same ICU admission
* Have undergone 1 or more SBTs where the SBT was clearly documented in the chart and/or the PS was reduced to the SBT level of 8 or less during the 24 hour period prior to randomization
* Already have a tracheostomy
* Are moribund or expected to die.

Where it's running

• Royal Alexandra Hospital
  Edmonton, Alberta, Canada Recruiting
• St. Boniface Hospital
  Winnipeg, Manitoba, Canada Recruiting
• Health Sciences Centre Winnipeg
  Winnipeg, Manitoba, Canada Recruiting
• Kingston Health Sciences Centre
  Kingston, Ontario, Canada Recruiting
• The Ottawa Hospital
  Ottawa, Ontario, Canada Recruiting
• Queensway Carleton Hospital
  Ottawa, Ontario, Canada Recruiting

Study contacts

• Principal investigator: Karen Burns, MD PhD FRCSC — Unity Health Toronto - St. Michael's Hospital
• Study coordinator: Andrew JE Seely, MD PhD FRCSC
• Email: aseely@toh.ca
• Phone: 613-737-8899

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Can a chest heart rhythm monitor help predict when ICU patients on a ventilator can breathe without the tube?

  This study tests if a chest monitor that tracks heart rhythm can help predict when adults in the ICU on a ventilator will be able to breathe on their own after extubation.

  Recruiting Seoul National University Hospital · Seoul · NCT07771101

• Inhaled isoflurane versus IV propofol for sedation of ventilated ICU patients

  This trial will test whether inhaled isoflurane delivered through the Sedaconda ACD‑S shortens time on the ventilator compared with intravenous propofol in adults needing deep sedation and expected to require mechanical ventilation for more than 48 hours.

  Recruiting at 12 sites Phase 4 Instituto de Investigación Hospital Universitario La Paz · Orihuela, Alicante and 21 other locations · NCT07000526

• One-time Pain Reprocessing Therapy session for chronic pain at The Ottawa Hospital

  A single four-hour session of Pain Reprocessing Therapy is being tested to see if it can help adults with chronic pain feel better and have less pain.

  Recruiting Ottawa Hospital Research Institute · Ottawa, Ontario · NCT07919626

• Blood Transfusion Thresholds During Major Surgery

  This study tests whether a higher versus lower blood transfusion threshold during surgery helps reduce serious complications or death after major surgery.

  Recruiting Ottawa Hospital Research Institute · Ottawa, Ontario and 1 other locations · NCT07748663

• Brain scans to find links between brain activity and knee replacement outcomes

  This study uses brain MRI before and after knee replacement to see if patterns of brain activity can predict which patients will be satisfied with their surgery.

  Recruiting Ottawa Hospital Research Institute · Ottawa, Ontario · NCT07464080

• Safety of perioperative blood thinner management in people with cancer undergoing surgery or procedures

  This study tests how safe current practices are for stopping or continuing blood thinners in adults with cancer who are having surgery or procedures, to see if bleeding or clots are affected.

  Recruiting Ottawa Hospital Research Institute · Ottawa · NCT07372716

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.