In October 2018 the Journal of the American Medical Association (JAMA) published online the results of The Breathe Randomised Clinical Trial.
This study asked whether in adults in whom weaning from invasive mechanical ventilation is difficult, does early extubation using a protocolised non-invasive weaning regimen reduce the time to liberation from ventilation compared with protocolised invasive weaning?
Breathe was a multi-centre clinical trial that enrolled patients from 41 ICUs in the UK between March 2013 and October 2016. The study included 364 adults and demonstrated that protocolised weaning with early extubation to non-invasive ventilation compared with invasive weaning did not significantly shorten time to liberation from all forms of mechanical ventilation.
One of the recruiting centres was the University Hospitals Birmingham NHS Foundation Trust, where Dr Catherine Snelson, Clinical Service Lead for Critical Care and SRMRC Project Lead, was the Principal Investigator (PI). The Nursing and Delivery teams from the NIHR SRMRC supported this study locally and were the second top recruiters nationally, recruiting 51 patients to the main arm of the trial.
This project was funded by the NIHR Health Technology Assessment Programme (project HTA 10/134) and supported by the Intensive Care Foundation. The trial was co-sponsored by the Heart of England NHS Foundation Trust and the University of Warwick.
Perkins GD, Mistry D, Gates S, Gao F, Snelson C, Hart N et al. Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Weaning on Time to Liberation From Mechanical Ventilation Among Patients With Respiratory Failure: The Breathe Randomized Clinical Trial. JAMA. 2018 Oct 22. doi: 10.1001/jama.2018.13763. [Epub ahead of print].
