Titre :

T-piece versus pressure-support ventilation for spontaneous breathing trials before extubation in patients at high risk of reintubation: protocol for a multicentre, randomised controlled trial (TIP-EX)

Auteur(s) :

Thille, Arnaud W [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Coudroy, Rémi [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Gacouin, Arnaud [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Ehrmann, Stephan [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Contou, Damien [Auteur]
Centre Hospitalier Victor Dupouy
Dangers, Laurence [Auteur]
Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion]
Romen, Antoine [Auteur]
Centre hospitalier de Pau
Guitton, Christophe [Auteur]
Centre Hospitalier Le Mans (CH Le Mans)
Lacave, Guillaume [Auteur]
Centre Hospitalier de Versailles André Mignot [CHV]
Quenot, Jean-Pierre [Auteur]
CHU Dijon
Lacombe, Béatrice [Auteur]
Pradel, Gael [Auteur]
CIC - CHU Henri Mondor
Terzi, Nicolas [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Prat, Gwenael [Auteur]
CHRU Brest - Service de Réanimation Médicale [CHU - BREST - Réa Med]
Labro, Guylaine [Auteur]
Centre Hospitalier Emile Muller [Mulhouse] [CH E.Muller Mulhouse]
Reignier, Jean [Auteur]
Service d'anesthésie et réanimation chirurgicale [Nantes]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Beduneau, Gaetan [Auteur]
Service de Réanimation Médicale [CHU Rouen]
Dellamonica, Jean [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Nay, Mai-Anh [Auteur]
Centre Hospitalier Régional d'Orléans [CHRO]
Rouze, Anahita [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Delbove, Agathe [Auteur]
Centre hospitalier Bretagne Atlantique (Morbihan) [CHBA]
Sedillot, Nicholas [Auteur]
Mira, Jean-Paul [Auteur]
Hôpital Cochin [AP-HP]
Bourenne, Jeremy [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Lautrette, Alexandre [Auteur]
Centre Jean Perrin [Clermont-Ferrand] [UNICANCER/CJP]
Argaud, Laurent [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Levrat, Quentin [Auteur]
Devaquet, Jérôme [Auteur]
Hôpital Foch [Suresnes]
Vivier, Emmanuel [Auteur]
Centre hospitalier Saint Joseph - Saint Luc [Lyon]
Azais, Marie-Ange [Auteur]
Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon [CHD Vendée]
Leroy, Christophe [Auteur]
Centre Hospitalier Emile Roux [Le Puy-en-Velay] [CH Le Puy]
Dres, Martin [Auteur]

Robert, René [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Ragot, Stéphanie [Auteur]
INSERM CIC 0802 [INSERM - CHU de Poitiers]
Frat, Jean-Pierre [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]

Titre de la revue :

BMJ Open

Nom court de la revue :

BMJ Open

Numéro :

10

Pagination :

e042619

Éditeur :

BMJ

Date de publication :

2020-11

ISSN :

1756-1833

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

IntroductionIn intensive care unit (ICU), the decision of extubation is a critical time because mortality is particularly high in case of reintubation. To reduce that risk, guidelines recommend to systematically perform a ...
Lire la suite >IntroductionIn intensive care unit (ICU), the decision of extubation is a critical time because mortality is particularly high in case of reintubation. To reduce that risk, guidelines recommend to systematically perform a spontaneous breathing trial (SBT) before extubation in order to mimic the postextubation physiological conditions. SBT is usually performed with a T-piece disconnecting the patient from the ventilator or with low levels of pressure-support ventilation (PSV). However, work of breathing is lower during PSV than during T-piece. Consequently, while PSV trial may hasten extubation, it may also increase the risk of reintubation. We hypothesise that, compared with T-piece, SBT performed using PSV may hasten extubation without increasing the risk of reintubation.Methods and analysisThis study is an investigator-initiated, multicentre randomised controlled trial comparing T-piece vs PSV for SBTs in patients at high risk of reintubation in ICUs. Nine hundred patients will be randomised with a 1:1 ratio in two groups according to the type of SBT. The primary outcome is the number of ventilator-free days at day 28, defined as the number of days alive and without invasive mechanical ventilation between the initial SBT (day 1) and day 28. Secondary outcomes include the number of days between the initial SBT and the first extubation attempt, weaning difficulty, the number of patients extubated after the initial SBT and not reintubated within the following 72 hours, the number of patients extubated within the 7 days following the initial SBT, the number of patients reintubated within the 7 days following extubation, in-ICU length of stay and mortality in ICU, at day 28 and at day 90.Ethics and disseminationThe study has been approved by the central ethics committee ‘Ile de France V’ (2019-A02151-56) and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT04227639.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CNRS

Collections :

• Autres travaux scientifiques

Équipe(s) de recherche :

Glycobiology in fungal Pathogenesis and Clinical Applications

Date de dépôt :

2021-07-15T09:28:21Z
2021-07-16T12:37:56Z