Two ways to support breathing during ventilator weaning in adults
Automatic Tube Compensation vs. Pressure Support Ventilation During Spontaneous Breathing Trials in Critically Ill Adults: A Cluster-Randomized, Cluster-Crossover Trial
This will test whether automatic tube compensation or pressure support ventilation helps adults on a ventilator for more than 24 hours get their breathing tube removed successfully.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 880 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Rush University Medical Center Academic / other |
| Locations | 1 site (Chicago, Illinois) |
| Trial ID | NCT07005505 on ClinicalTrials.gov |
What this trial studies
This cluster-randomized, cluster-crossover trial at Rush University Medical Center compares pressure support ventilation (PSV) and automatic tube compensation (ATC) during spontaneous breathing trials for critically ill adults who have received invasive mechanical ventilation for at least 24 hours. Clinical units alternate which SBT mode is used as standard care, and eligible patients who pass the SBT screen receive the assigned mode as part of routine weaning. The trial tracks successful extubation after the SBT as the main outcome and records reintubation and other clinical outcomes. Both PSV and ATC are used in practice, and the trial aims to determine which mode leads to more reliable ventilator liberation.
Who should consider this trial
Good fit: Adults (18+) admitted to the ICU who have been on invasive mechanical ventilation for at least 24 hours and who pass the spontaneous breathing trial screening are ideal candidates.
Not a fit: Patients with tracheostomies, Do-Not-Intubate orders, pregnancy, prisoners, or those not being considered for extubation would not be eligible or likely to benefit.
Why it matters
Potential benefit: If one mode proves better, it could increase successful extubation rates and shorten time on mechanical ventilation, lowering related complications.
How similar studies have performed: Smaller physiologic studies and limited clinical trials suggest ATC can reduce work of breathing, but large randomized comparisons of ATC versus PSV for extubation outcomes are lacking.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Admitted to intensive care unit (ICU) * Age 18 years or older * Requiring invasive mechanical ventilation for at least 24 hours * Pass spontaneous breathing trial screen criteria Exclusion Criteria: * Clinical decision made not to proceed with extubation regardless of spontaneous breathing trial (SBT) results * Do not intubate (DNI) order * Presence of tracheostomy * Pregnancy * Known prisoner * Immediate need for extubation, self-extubation, or unplanned extubation that precludes safe performance of study procedures * Enrolled in another clinical trial that impacts ventilator weaning or liberation
Where this trial is running
Chicago, Illinois
- Rush University Medical Center — Chicago, Illinois, United States (Recruiting)
Study contacts
- Study coordinator: Jie Li, PhD
- Email: Jie_Li@rush.edu
- Phone: 312-563-4643
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.