CDC Prevention Epicenters Wake Up and Breathe Collaborative

Harvard Pilgrim Health Care

Status: Completed

Conditions: Ventilator-associated Pneumonia

Treatments: Procedure: Daily SAT & SBT

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT01583413

3U54CK000172-01S1 (U.S. NIH Grant/Contract)

PH000410A-2

Details and patient eligibility

About

Ventilator-associated pneumonia (VAP) is a common complication of mechanical ventilation associated with significant morbidity, including prolongation of mechanical ventilation and increased ICU and hospital length-of-stay. Numerous strategies have been proposed to decrease the occurrence of VAP among ventilated patients. Most notably, optimizing the use of daily sedative interruptions and daily spontaneous breathing trials can improve sedative management, decrease ventilator time, improve outcomes for mechanically ventilated patients,and possibly decrease VAP.Combining daily sedative interruption with daily spontaneous breathing trials confers additive improvement in ventilator days, intensive care days, and possibly mortality compared to daily spontaneous breathing trials alone.

The primary aim of this study is to determine the impact of an opt-out protocol for paired daily sedative interruptions and spontaneous breathing trials on VAP rates using a new streamlined VAP definition. The investigators will evaluate the responsiveness of CDC's proposed new surveillance definitions for ventilator-associated events to this quality improvement initiative. The study will be nested within the Epicenters Streamlined versus Conventional VAP Surveillance Study. Nine of the 18 hospitals in the larger study will be participating in this intervention arm.

Enrollment: 3,342 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• all patients in participating units on mechanical ventilation for at least one calendar day beting treated with continuous sedatives or standing orders for sedatives. Patients receiving mechanical ventilation through either an endotracheal or tracheostomy tube will be eligible.

Exclusion criteria

• moribund status or plans for withdrawal of life support

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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3,342 participants in 1 patient group

Opt Out Protocol

Experimental group

Treatment:

Procedure: Daily SAT & SBT