The iCareWean protocol on weaning from mechanical ventilation: A Single-blinded multi-centre randomised control trial comparing an open-loop decision support system and routine care, in the general Intensive Care Unit
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction: Automated systems for ventilator management to date have been either fully heuristic rule-based systems or based on a combination of simple physiological models and rules. These have been shown to reduce the duration of mechanical ventilation in simple to wean patients. At present there are no published studies that evaluate the effect of systems that utilise detailed physiological descriptions of the individual patient.The BEACON Caresystem© is a model-based decision support system that utilises mathematical models of patients’ physiology in combination with models of clinical preferences to provide advice on appropriate ventilator settings. An individual physiological description may be particularly advantageous in selecting the appropriate therapy for a complex, heterogeneous, ICU patient population. Methods & Analysis: iCareWean is a single-blinded, multicentre, prospective randomised control trial evaluating management of mechanical ventilation as directed by the BEACON Caresystem© compared to that of current care, in the general intensive care setting. The trial will enrol 274 participants across multiple London NHS Intensive Care Units. The trial will utilise a primary outcome of duration of mechanical ventilation until successful extubation.Ethics & dissemination: Safety oversight will be under the direction of an independent committee of the study sponsor. Study approval was obtained from the regional ethics committee of the HRA, REC reference: 17/LO/0887. IRAS reference: 226610. Results will be disseminated through international critical care conference/symposium and publication in peer-reviewed journal.Trial Registration details: ClinicalTrials.gov under NCT03249623. This research is registered with the National Institute for Health Research (NIHR) under CPMS ID: 34831.
Date Issued
2020-09-02
Date Acceptance
2020-07-17
Citation
BMJ Open, 2020, 10 (9), pp.1-8
ISSN
2044-6055
Publisher
BMJ Journals
Start Page
1
End Page
8
Journal / Book Title
BMJ Open
Volume
10
Issue
9
Copyright Statement
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
https://bmjopen.bmj.com/content/10/9/e042145
Subjects
adult intensive & critical care
physiology
respiratory medicine (see thoracic medicine)
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status
Published
Date Publish Online
2020-09-02