Extubation Strategies in Neuro-Intensive Care Unit Patients and Associations With Outcome.

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1750 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-09-06

Study Completion Date

2021-01-01

Brief Summary

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Rationale Prolonged mechanical ventilation (MV) is common in patients with severe Brain Injury (BI). Guidelines for the management of extubation are largely lacking for patients with BI, and the role of tracheostomy is highly uncertain. More important, data on practice of management of extubation is yet underreported, as is the use of tracheotomy in this specific subset of critical care patients.

Objective The objective of this prospective observational study is to describe the management of extubation and tracheostomy in intensive care unit (ICU) patients with BI. The aim is to describe the incidence of extubation failure and the rate of tracheostomy.

Study design The "Extubation strategies in Neuro-Intensive care unit patients, and associations with Outcomes (ENIO)" is an observational multicentre international cohort study.

Study population The investigators will include patients undergoing BI, with an initial Glasgow Coma Score ≤ 12 and with a delivered duration of mechanical ventilation (MV) ≥ 24 hours at ICU admission. The inclusion period will last 6 months in total, and each centre is expected to include at least 24 patients during this period. With over 60 ICUs participating worldwide, we expect to include 1500 patients.

Main parameters Parameters to be collected include: general neurological management, ventilatory management, general ICU complications, specific data on extubation and tracheostomy, general in-ICU outcomes and in-hospital mortality.

Nature and extent of the burden and risks associated with participation Because of the observational design of the study using routinely collected data, there is no additional burden for the patient. Collection of data from ICU charts and/or (written or electronic) medical records systems bears no risk to the patients.

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Detailed Description

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Conditions

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Brain Injuries

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Patients with brain injury and mechanical ventilation exposed to extubation/tracheostomy

Extubation and/or tracheostomy if applicable

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years' old
* Patients admitted in a ICU for a central neurological pathology, listed as follows, with estimated or clinically evaluated Glasgow Coma Score ≤12 before endo-tracheal intubation, with anomaly on brain CT-scan and requiring effective invasive mechanical ventilation ≥ 24 hours are eligible to the study:
* Traumatic Brain Injury
* Aneurysmal Subarachnoid haemorrhage
* Intra-Cranial Haemorrhage
* Ischemic Stroke
* Central Nervous System Infection (Abscess, Empyema, Meningitides, Encephalitis…)
* Brain Tumour
* Patient with an attempt of extubation and/or performance of a tracheostomy

Exclusion Criteria

* Patients \< 18 years' old
* Patients with ongoing pregnancy
* Patients with spine cord injury above T4
* Resuscitated cardiac arrest
* Withdrawal of Life-Sustaining Treatment (WLST) in the first 24 hours

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No