Mechanical Ventilator Weaning in Chronically Ventilated Patients

Launched by UNIVERSITY OF CALIFORNIA, LOS ANGELES · May 8, 2025

Keywords

ClinConnect Summary

This clinical trial is studying the best ways to help patients who have been on a mechanical ventilator for a long time breathe on their own. Mechanical ventilation is a life-saving treatment for people who struggle to breathe, but some patients find it hard to stop using the ventilator. The study compares two methods for weaning patients off the ventilator: one method involves a faster approach called Pressure Support Ventilation (PSV), while the other is a more gradual method called Therapist Implemented Patient Specific (TIPS) weaning. Researchers will track how successful each method is over a 30-day period.

To participate in this trial, patients must have been on a ventilator for at least 21 days and have a secure tracheostomy (a tube placed in the neck to help with breathing). The trial is open to all adults who meet these criteria. After joining the study, participants will undergo a breathing test to see if they can breathe with little or no help from the ventilator. Depending on the results, they will be assigned to one of the two weaning methods. Importantly, the study will not change the usual medical care they receive, and adjustments to the weaning strategy can be made if needed.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Patients requiring positive pressure mechanical ventilation for at least 21 days prior to BRH admission and
• • 2. Have a secure tracheostomy.
• Exclusion Criteria:
• • 1. Inability to obtain informed consent from patient or DPOA
• • 2. Incarcerated patients
• • 3. Patients with less than 3 months of life expectancy
• • 4. Patients requiring vasopressor medication to stabilize blood pressure on admission
• • 5. Systolic blood pressure less than 90mmHg on admission
• • 6. Pulse less than 50 or greater than 130 beats per minute or change by more than 20 from baseline on admission
• • 7. Respiratory rate greater than 35/min
• • 8. Oxygen saturation less than 90%
• • 9. PEEP\>5cmH2O
• • 10. Lung tidal volume less than 250ml despite MV support
• • 11. At least one previous admission to BRH with unsuccessful ventilator liberation attempt
• • 12. Length of Stay (LOS) at BRH less than 24hours
• • 13. Patients pass spontaneous breathing trial (SBT) on D1 and eligible for cool aerosol, except if they fail SBT on D2 and require continued MV