Comparison of Two Ventilator Mode During the Night: New Strategy of Mechanical Ventilation Weaning
NCT ID: NCT01573481
Last Updated: 2025-09-19
Study Results
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Basic Information
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COMPLETED
NA
19 participants
INTERVENTIONAL
2012-01-31
2015-01-31
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Pressure support ventilation
Patients in this group are ventilated during the night (10 PM to 9 AM) with pressure support ventilation mode. The level of the pressure support is the same as the previous day.
During the day (9 AM to 10 PM), patients are ventilated with pressure support ventilation (the level of pressure support is progressively decreased).
pressure support ventilation
Patients in this group are ventilated during the night with pressure support ventilation mode. The level of the pressure support is the same as the previous day.
Pressure controlled ventilation
Patients in this group are ventilated during the night (10 PM to 9 AM) with pressure controlled ventilation mode. The level of inspiratory pressure is set to 20 cm H2O and the respiratory rate is adjusted to avoid any spontaneous breathing (respiratory rate \> or equal to 12 breath per min). During the day (9 AM to 10 PM), patients are ventilated with pressure support ventilation (the level of pressure support is progressively decreased).
Pressure controlled ventilation
Patients in this group are ventilated during the night (10 PM to 9 AM) with pressure controlled ventilation mode. The level of inspiratory pressure is set to 20 cm H2O and the respiratory rate is adjusted to avoid any spontaneous breathing (respiratory rate \> or equal to 12 breath per min).
Interventions
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pressure support ventilation
Patients in this group are ventilated during the night with pressure support ventilation mode. The level of the pressure support is the same as the previous day.
Pressure controlled ventilation
Patients in this group are ventilated during the night (10 PM to 9 AM) with pressure controlled ventilation mode. The level of inspiratory pressure is set to 20 cm H2O and the respiratory rate is adjusted to avoid any spontaneous breathing (respiratory rate \> or equal to 12 breath per min).
Eligibility Criteria
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Inclusion Criteria
* The patients is hospitalized in respiratory and critical care unit (university hospital of AMIENS, FRANCE)
* the patient is mechanically ventilated (ventilator model : puritan-bennett B840)
* Pulmonary disease,chronic obstructive (Spirometry and Blood Gas Analysis in chronic state before admission)
* stable cardiovascular status (cardiac frequency \< 140 beats/min and systolic blood pressure : 90-160 mmHg without catecholamines)
* midazolam \< 0,05mg/kg/h
* sufentanyl \< 0,05µ/kg/h
* the disorder that caused respiratory failure and prompted mechanical ventilation is treated
* the clinician suspects the patient may be ready to begin the weaning process
* inspiratory oxygen fraction (FiO2) \< 50%
* positive end-expiratory pressure \< or equal 8cmH2O
* during the day, the patient tolerate pressure support ventilation (pressure support level \< 15cmH2O
* respiratory frequency (FR) \< 35 breaths/min
* tidal volume (VT) \> 5ml/kg
* PaO2/FiO2 \> 200 mmHg
* FR/VT \< 105 breaths/min/L
Exclusion Criteria
* narcolepsy
* Encephalopathy, Metabolic AND Encephalitis
18 Years
ALL
No
Sponsors
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Centre Hospitalier Universitaire, Amiens
OTHER
Responsible Party
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Principal Investigators
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ANDREJAK Claire, MD
Role: PRINCIPAL_INVESTIGATOR
CHU Amiens
JOUNIEAUX Vincent, MD PhD
Role: STUDY_DIRECTOR
CHU Amiens
BASILLE Damien, MD
Role: PRINCIPAL_INVESTIGATOR
CHU Amiens
ROGER Pierre-Alexandre, MD
Role: PRINCIPAL_INVESTIGATOR
CHU Amiens
ROSE Dominique, MD
Role: PRINCIPAL_INVESTIGATOR
CHU Amiens
MONCONDUIT Julien, MD
Role: PRINCIPAL_INVESTIGATOR
CHU Amiens
Locations
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Pneumologie et Réanimation Respiratoire
Amiens, , France
Countries
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References
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Boles JM, Bion J, Connors A, Herridge M, Marsh B, Melot C, Pearl R, Silverman H, Stanchina M, Vieillard-Baron A, Welte T. Weaning from mechanical ventilation. Eur Respir J. 2007 May;29(5):1033-56. doi: 10.1183/09031936.00010206.
Epstein SK, Ciubotaru RL, Wong JB. Effect of failed extubation on the outcome of mechanical ventilation. Chest. 1997 Jul;112(1):186-92. doi: 10.1378/chest.112.1.186.
Brochard L, Rauss A, Benito S, Conti G, Mancebo J, Rekik N, Gasparetto A, Lemaire F. Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med. 1994 Oct;150(4):896-903. doi: 10.1164/ajrccm.150.4.7921460.
Esteban A, Frutos F, Tobin MJ, Alia I, Solsona JF, Valverdu I, Fernandez R, de la Cal MA, Benito S, Tomas R, et al. A comparison of four methods of weaning patients from mechanical ventilation. Spanish Lung Failure Collaborative Group. N Engl J Med. 1995 Feb 9;332(6):345-50. doi: 10.1056/NEJM199502093320601.
Esteban A, Alia I. Clinical management of weaning from mechanical ventilation. Intensive Care Med. 1998 Oct;24(10):999-1008. doi: 10.1007/s001340050708. No abstract available.
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Parreira VF, Delguste P, Jounieaux V, Aubert G, Dury M, Rodenstein DO. Effectiveness of controlled and spontaneous modes in nasal two-level positive pressure ventilation in awake and asleep normal subjects. Chest. 1997 Nov 5;112(5):1267-77. doi: 10.1378/chest.112.5.1267.
Parreira VF, Delguste P, Jounieaux V, Aubert G, Dury M, Rodenstein DO. Glottic aperture and effective minute ventilation during nasal two-level positive pressure ventilation in spontaneous mode. Am J Respir Crit Care Med. 1996 Dec;154(6 Pt 1):1857-63. doi: 10.1164/ajrccm.154.6.8970381.
Bosma K, Ferreyra G, Ambrogio C, Pasero D, Mirabella L, Braghiroli A, Appendini L, Mascia L, Ranieri VM. Patient-ventilator interaction and sleep in mechanically ventilated patients: pressure support versus proportional assist ventilation. Crit Care Med. 2007 Apr;35(4):1048-54. doi: 10.1097/01.CCM.0000260055.64235.7C.
Toublanc B, Rose D, Glerant JC, Francois G, Mayeux I, Rodenstein D, Jounieaux V. Assist-control ventilation vs. low levels of pressure support ventilation on sleep quality in intubated ICU patients. Intensive Care Med. 2007 Jul;33(7):1148-1154. doi: 10.1007/s00134-007-0659-2. Epub 2007 May 11.
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Andrejak C, Monconduit J, Rose D, Toublanc B, Mayeux I, Rodenstein D, Jounieaux V. Does using pressure-controlled ventilation to rest respiratory muscles improve sleep in ICU patients? Respir Med. 2013 Apr;107(4):534-41. doi: 10.1016/j.rmed.2012.12.012. Epub 2013 Feb 4.
Other Identifiers
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PI2012_843_0016
Identifier Type: -
Identifier Source: org_study_id
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