protocolSection identificationModule nctId: NCT06288724, orgStudyIdInfo id: NatIntensive, briefTitle: MOdifiable facTors to Improve VentilAtion ThErapy in ICU, acronym: MOTIVATE-ICU, statusModule overallStatus: NOT_YET_RECRUITING, startDateStruct date: 2024-03, primaryCompletionDateStruct date: 2024-09, completionDateStruct date: 2024-09, studyFirstPostDateStruct date: 2024-03-01, lastUpdatePostDateStruct date: 2024-03-01, sponsorCollaboratorsModule leadSponsor name: Nat Intensive Care Surveillance - MORU, class: OTHER, collaborators name: D'Or Institute for Research and Education, collaborators name: University of Oxford, collaborators name: Wellcome Trust, collaborators name: Makerere University, descriptionModule briefSummary: ABSTRACT Introduction: Invasively ventilated patients in low and middle-income countries (LMICs) experience significantly higher mortality compared to those in High income countries (HICs). Direct application of HIC strategies to LMICs maybe ineffective due to context-specific challenges. This study aims to leverage the Intensive Care Registry of Uganda (ICRU) to identify ICU structural and process-related modifiable factors that impact patient outcomes in a low income country.Methods: The MOTIVATE-ICU is a prospective multicentre observational study in invasively ventilated patients. It involves a registry-embedded component examining patient- and process-related factors and a cross-sectional survey on ICU organizational structures. Inclusion criteria encompass patients aged ≥ 15 years undergoing IMV in Ugandan ICUs. Primary outcomes are ICU mortality, ICU length of stay (LOS), and duration of ventilation. Secondary outcomes include ventilator-associated complications, non-pulmonary organ support. tTracheostomy outcomes will be explored in a pre-planned substudy. Factors potentially associated with outcomes will be categorized into two groups; non-modifiable factors and potentially modifiable. Non-modifiable factors will include patient-related factors like age, comorbidities and illness severity; potentially modifiable factors include processes of care (e.g. sedation levels) and ICU organizational structure (e.g. staffing patterns). Multilevel multivariable logistic regression will be utilized to study associations, with both patient and ICU level fixed effects considered.Ethics and Dissemination: Given its observational nature, this study seeks a waiver for patient individual informed consent. Data anonymization ensures patient privacy. Following the principles of the Declaration of Helsinki, relevant ethical approvals will be acquired. Study findings will be disseminated through conferences and peer-reviewed journals., conditionsModule conditions: Critical Illness, conditions: Invasive Mechanical Ventilation, conditions: ICU Mortality, conditions: Developing Countries, conditions: Risk Factors, designModule studyType: OBSERVATIONAL, designInfo observationalModel: COHORT, timePerspective: PROSPECTIVE, enrollmentInfo count: 625, type: ESTIMATED, outcomesModule primaryOutcomes measure: ICU mortality, primaryOutcomes measure: ICU Length of Stay, primaryOutcomes measure: Duration of mechanical ventilation, secondaryOutcomes measure: Duration of non-pulmonary organ support, secondaryOutcomes measure: ICU-Free days, secondaryOutcomes measure: Ventilator-free days, secondaryOutcomes measure: Ventilator-associated Pneumonia, secondaryOutcomes measure: Tracheobronchitis, secondaryOutcomes measure: Non-infectious Pulmonary complication, secondaryOutcomes measure: Readmission, secondaryOutcomes measure: Unplanned extubations, secondaryOutcomes measure: Tracheostomy related outcomes, eligibilityModule sex: ALL, minimumAge: 15 Years, stdAges: CHILD, stdAges: ADULT, stdAges: OLDER_ADULT, contactsLocationsModule, hasResults: False