Comparison of Two Chest Radiograph Prescription Strategies in Intensive Care Unit

NCT ID: NCT00893672

Last Updated: 2009-05-06

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 849 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2006-12-31
• Study Completion Date: 2009-04-30

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.

Conditions

Patient Care; Quality of Health Care; Intensive Care Units; Ventilation, Mechanical

Study Design

• Observational Model Type: CASE_CROSSOVER
• Study Time Perspective: PROSPECTIVE

Study Groups

1

Routine strategy of chest radiograph prescription

No interventions assigned to this group

2

On-demand strategy of chest radiograph prescription

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

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

Exclusion Criteria

• Patients with mechanical ventilation lasting less than 2 days

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role: lead

Responsible Party

Department Clinical Research of Developpement

Principal Investigators

Bertrand GUIDET, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Assistance Publique - Hôpitaux de Paris

Locations

Hopital Saint-Antoine

Paris, Paris, France

Countries

France

References

Hejblum G, Chalumeau-Lemoine L, Ioos V, Boelle PY, Salomon L, Simon T, Vibert JF, Guidet B. Comparison of routine and on-demand prescription of chest radiographs in mechanically ventilated adults: a multicentre, cluster-randomised, two-period crossover study. Lancet. 2009 Nov 14;374(9702):1687-93. doi: 10.1016/S0140-6736(09)61459-8. Epub 2009 Nov 4.

Reference Type: DERIVED

PMID: 19896184 (View on PubMed)

Other Identifiers

SCR06006

Identifier Type: -

Identifier Source: org_study_id