Comparison of Two Chest Radiograph Prescription Strategies in Intensive Care Unit

Completed

• Conditions: Quality of Health Care; Intensive Care Units; Ventilation, Mechanical; Patient Care

• Registration Number: NCT00893672
• Lead Sponsor: Assistance Publique - Hôpitaux de Paris

Brief Summary

Current guidelines recommend Routine daily chest radiographs (CXRs) for mechanically ventilated patients in intensive care units (ICUs). However, some ICUs have shifted to an On-demand strategy, in which this CXR is only prescribed if warranted by the patient's status at the morning physical examination. Here the investigators compared Routine and On-demand strategies in 21 French ICUs. The working hypothesis was that CXR prescriptions would fall by at least 20% with the On-demand strategy, with no reduction in quality of care.

Detailed Description

Based on a cluster-randomized two-period two-strategies cross-over design, respectively 11 and 10 participating ICUs applied the Routine and On-demand strategies during the first period, each enrolling 20 consecutive patients requiring mechanical ventilation for at least two days. Each ICUs applied then applied the alternative strategy during the second period, again enrolling 20 consecutive patients.

Study Timeline

• Study Start: 2006-12
• Primary Completion: 2007-08
• Study Completion: 2009-04
• Status Verified: 2009-05
• Study First Submitted: 2009-05-05
• Study First Submitted QC: 2009-05-05
• Last Update Submitted: 2009-05-05
• Study First Posted: 2009-05-06
• Last Update Posted: 2009-05-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 849

Inclusion Criteria

• All newly admitted adult patients receiving mechanical ventilation at the time of the morning visit-any day during their ICU stay

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Exclusion Criteria

• Patients with mechanical ventilation lasting less than 2 days

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Average number of chest radiographs per patient-day during mechanical ventilation	Every patient-day during mechanical ventilation.

Secondary Outcome Measures

Name	Time	Method
Average duration of mechanical ventilation	During the inpatient stay in ICU
Number of radiographs with new findings leading to therapeutic or diagnostic interventions	During the inpatient stay in ICU
Average length of stay	During the inpatient stay in ICU
Mortality rate in ICU	During the inpatient stay in ICU

Trial Locations

Locations (1)

Hopital Saint-Antoine; 🇫🇷 Paris, France