Arterial Blood Gases in Weaning of Mechanical VEntilation

Study Overview
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Brief Summary
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Weaning of mechanical ventilation is an important phase of ICU (Intensive Care Unit) patient hospitalization. Patients have to pass a spontaneous breathing trial, can have a phase of pause with mechanical ventilation before extubation and then can be weaned of invasive mechanical ventilation. Spontaneous breathing trial can be performed with a T-Tube or with Pressure support without PEEP (End Expiratory Positive Pressure) . Duration of spontaneous breathing trial range from 30 minutes to 120 minutes. Some clinicians performed an arterial blood gases at the end of the spontaneous breathing trial but this practice is not really defined and clearly explained in recommendations. Patients can benefit of ventilation support after extubation like non invasive pressure support or high flow nasal canulae. The procedure can be very different from a center to another, especially for arterial blood gases at the end of spontaneous breathing trial. Our aim is to observe in a multicenter study the daily practice of weaning of mechanical ventilation especially for arterial blood gases.

Official Title
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Arterial Blood Gases in Weaning of Mechanical VEntilation

Conditions
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Weaning of Mechanical Ventilation

Intervention / Treatment
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* Procedure: Weaning of mechanical ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Older than 18 years first attempt of weaning of mechanical ventilation Exclusion Criteria: withholding of life sustaining therapies spontaneous breathing trial unsuccessful

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Weaning of mechanical ventilation|Weaning of mechanical ventilation is the time when the patient is ready for separation from ventilatory support until breathing without invasive support|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Type of spontaneous breathing trial performed | Spontaneous breathing trial is performed either with pressure support or with a T-Piece | In the 24 hours of spontaneous breathing trial | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Arterial blood gases at the end of spontaneous breathing trial | Arterial blood gases are sometime performed at the end of the spontaneous breathing trial during weaning of mechanical ventilation. Spontaneous breathing trial takes from 30 to 120 minutes | In the hour of spontaneous breathing trial | 
| Duration of spontaneous breathing trial | Duration in minutes | The day of the spontaneous breathing trial | 
| Ventilatory procedure at the end of spontaneous breathing trial: either immediate extubation or pressure support ventilation with intubation | the procedure at the end of spontaneous: the patient is either extubated immediately or benefit of about one hour of invasive pressure support with the settings before spontaneous breathing trial until extubation. Procedure of extubation is differed of about one hour. | The day of extubation if extubation performed | 
| Frequency and type of ventilatory support after extubation | Ventilatory is either not performed or if performed, with pressure support or high flow oxygen nasal canulae | The day of extubation if extubation performed | 
| Need for reintubation | Reintubation is the need to reintubate the patient because of extubation failure | During the seven days following extubation | 
| Etiology of reintubation | The cause of reintubation (pulmonary edema, infectious pulmonary disease...) | During the seven days following extubation | 
| Death | If the patient died | The first 28 days following extubation | 
| Ventilator associated pneumoniae | Pneumoniae acquired after more than 48 hours of mechanical ventilation | From 48 hours after extubation until extubation | 
| days alive without mechanical ventilation | The number of days without invasive mechanical ventilation support during the first 28 days of intensive care hospitalization. | during the first 28 days of intensive care hospitalization. |