Comparison of Two Chest Radiograph Prescription Strategies in Intensive Care Unit (RARE)

Assistance Publique - Hôpitaux de Paris

Status: Completed

Conditions: Ventilation, Mechanical; Intensive Care Units; Quality of Health Care; Patient Care

Study type: Observational

Funder types: Other

Identifiers

NCT00893672

SCR06006

Details and patient eligibility

About

Current guidelines recommend Routine daily chest radiographs (CXRs) for mechanically ventilated patients in intensive care units (ICUs). However, some ICUs have shifted to an On-demand strategy, in which this CXR is only prescribed if warranted by the patient's status at the morning physical examination. Here the investigators compared Routine and On-demand strategies in 21 French ICUs. The working hypothesis was that CXR prescriptions would fall by at least 20% with the On-demand strategy, with no reduction in quality of care.

Full description

Based on a cluster-randomized two-period two-strategies cross-over design, respectively 11 and 10 participating ICUs applied the Routine and On-demand strategies during the first period, each enrolling 20 consecutive patients requiring mechanical ventilation for at least two days. Each ICUs applied then applied the alternative strategy during the second period, again enrolling 20 consecutive patients.

Enrollment: 849 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All newly admitted adult patients receiving mechanical ventilation at the time of the morning visit-any day during their ICU stay

Exclusion criteria

• Patients with mechanical ventilation lasting less than 2 days

Trial design

849 participants in 2 patient groups

1

Description:

Routine strategy of chest radiograph prescription

2

Description:

On-demand strategy of chest radiograph prescription