Comparing pressure support ventilation and T-piece as methods of spontaneous breathing trials for weaning the ICU patients from ventialtor support .

Not yet recruiting

Conditions: Medical and Surgical,

Registration Number: CTRI/2023/05/053347

Lead Sponsor: Pt BD Sharma University of Health Sciences Rohtak Haryana

Brief Summary: Spontaneous breathing trial is a method to identify readiness of extubation by incorporating a technique which allows gradual decrease in mechanical support of ventilator. SBT can be conducted by different methods like T-piece breathing, low level pressure support ventilation with or without PEEP, low level continuous airway pressure and flow trigger with no pressure applied to airway. There are some advanced methods of SBT like closed-loop systems with intelligent modes, adaptive support ventilation (ASV), neurally adjusted ventilatory assist (NAVA), and proportional assisted ventilation (PAV). Low level PSV and T piece are most common methods used for SBT. Low level PSV includes a pressure of upto 8 cm H2O in adults and upto 10 cm H2O in pediatric patients. In T-piece trial, patients are disconnected from ventilator and put on t-tube with oxygen support of 9-11 litres /min. SBT can be given for 30 to 120 minutes and after that success of trial can be monitored using subjective and objective criteria.

Depending on success of these SBTs, weaning can be classified further according to different classifications to assess success of weaning. We will be using WIND criteria. According to the success of SBT patients will be classified in following four weaning groups: 1. Group NW: patients who never experienced any separation attempt (SA); 2. Group 1: the first SA resulted in termination of the weaning process within 1 day 3. Group 2: weaning was completed after more than 1 day but in less than 1 week after the first SA 4. Group 3: weaning was not terminated by 7 days after the first SA Patients who will not be weaned off after 7 days will be regarded as failure of weaning.

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Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 80

Inclusion Criteria

Patients with age more than 18 years who are mechanically ventilated for minimum 24 hours but less than 7 days who are ready for spontaneous breahting trial.

Exclusion Criteria

Patients with 1.
On vasopressor or inotropic support 2.
Patients with underlying COPD, interstitial lung disease, damaged lung parenchyma due to any cause, single lung bronchopleural fistula or having intercostal drain in situ.
Patients whose weaning was terminated due to cause unrelated to weaning process.
Inability to obtain consent.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Comparison between success of T-piece trial and pressure support ventilation	vitals recording and areterial blood gas analysis will be done at 20 minutes,40 minutes,and 60 minutes and second SBT will be given after 24 hours
for weaning according to WIND classification.	vitals recording and areterial blood gas analysis will be done at 20 minutes,40 minutes,and 60 minutes and second SBT will be given after 24 hours

Secondary Outcome Measures

Name	Time	Method
To assess number of spontaneous breathing trials given for weaning in each group.	second SBT will be given after 24 hours and repeated untill success upto 1 week

Trial Locations

Locations (1): PGIMS Rohtak Haryana
🇮🇳
Rohtak, HARYANA, India
PGIMS Rohtak Haryana
🇮🇳Rohtak, HARYANA, India
Alka
Principal investigator
8053305215
dahiyaalka1995@gmail.com