Respiratory Support and Treatment for Efficient and Cost-Effective Care
- Conditions
- Bronchiolitis
- Interventions
- Other: Clinical Decision Support (CDS)Device: HHFNC Weaning
- Registration Number
- NCT05909566
- Lead Sponsor
- Christopher Horvat
- Brief Summary
This project aims to answer the essential questions about the management of acute, pediatric respiratory illness, accelerate recovery from these all-too-common diseases, curb unnecessary costs of care, and demonstrate UPMC Children's Hospital of Pittsburgh's capabilities as the premier, world-class leader in the arena of pediatric learning healthcare systems. REST EEC will focus on the question of whether clinical decision support (CDS) facilitates the standardization of the initiation and weaning of heated high flow nasal cannula (HHFNC) for bronchiolitis.REST EEC will focus on whether the application of CDS improves adherence to a standardized guideline and leads to improved patient-centered outcomes.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 198
- <2 years of age Bronchiolitis WOB Score >2
- Immunocompromised
- Immunosuppressed
- Chronic lung disease
- Congenital heart disease with baseline cardiorespiratory manifestations
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description HHFNC Weaning Clinical Decision Support (CDS) Team does not receive clinical decision support reminders to wean the HHFNC HHFNC + Clinical decision Support Clinical Decision Support (CDS) Standardized HHFNC weaning coupled with clinical decision support consisting of electronic record embedded reminders to the clinical team to wean HHFNC HHFNC Weaning HHFNC Weaning Team does not receive clinical decision support reminders to wean the HHFNC HHFNC + Clinical decision Support HHFNC Weaning Standardized HHFNC weaning coupled with clinical decision support consisting of electronic record embedded reminders to the clinical team to wean HHFNC
- Primary Outcome Measures
Name Time Method HFNC duration Timeframe consists of a start time of either randomization or the last documentation of positive pressure ventilation (whichever is later) and the last documentation of HFNC in the electronic flowsheet, up to 30 days Amount of time patient is on HFNC
- Secondary Outcome Measures
Name Time Method Organ support free days From date of admission until the first day of ICU-based respiratory or cardiovascular organ support or discharge or date of death from any case, whichever came first, assessed up to 30 days Days alive and free of ICU-based respiratory or cardiovascular organ support
Respiratory support free days From date the start of respiratory support until the first documented respiratory support free day, up to 30 days Days alive and free of intensive care unit-based respiratory
PICU length of stay From data of admission to PICU to discharge from the PICU or death from any cause, whichever came first, assessed up to 90 days. Days admitted in the PICU. This is added to reconcile the plan to evaluate this outcome and its noted absence from this website, as pointed out by a reviewer while working to publish the trial design.
Hospital length of stay From date of admission until discharge or date of death from any cause, whichever came first, assessed up to 90 days. Days admitted in hospital
Time to oral intake From date of ending HHFNC until first documented oral intake, assessed up to 30 days Time from HHFNC and oral intake
Cost of hospitalization Days from admission to discharge from hospital or date of death, up to 90 days. Of note, an earlier outcome was listed for 90-day cost of care and the redundancy with this outcome was recognized, so the 90-day cost of care outcome was removed. Totality of expenses incurred by a hospital in providing its services and care
Mortality From date of admission until death from any cause, assessed up to 90 days Patient Death
Ostensible respiratory distress measured by a respiratory severity score Through study completion, an average of 1 week The product of mean airway pressure and the fraction of inspired oxygen
Trial Locations
- Locations (1)
UPMC Children's Hospital of Pittsburgh
🇺🇸Pittsburgh, Pennsylvania, United States