Some patients recovering from severe or critical illness on the Intensive Care Unit are treated with mechanical ventilation. This supports the patients’ breathing, reducing effort required to breathe in addition to providing extra oxygen if needed. Patients who have been very unwell, or need mechanical ventilation for more than a few days, may become dependent on the support provided and need training to breathe by themselves. This process is termed “weaning”. Patients usually undergo a tracheostomy, a hole through the neck into the trachea (windpipe), which is more comfortable than having the tube through the mouth. The sedation they need is then reduced and they are woken up, as the support provided by the ventilator is slowly reduced. For some patients, this process can take days or weeks, with complications and setbacks. The process is often uncomfortable, distressing and requires the resources of the intensive care unit, so it is important to try to understand how we can make the weaning process as effective and quick as possible. Current evidence suggests that we don’t yet understand many of the factors that influence the success of weaning, but that a consistent approach is likely to be beneficial. Current systems used to prescribe and monitor progress use different methods of documentation, including paper charts and electronic records, which can be difficult to interpret. A new device has been developed, the “Digitally Enhanced Liberation from Ventilation” or “DELVE” system which has been designed to improve the clinical team’s ability to prescribe the weaning plan, and interpret the patients’ progress. The DELVE system will also collect data which will help us to better understand some of the factors that influence rate of weaning. This trial is a feasibility study of this novel device in the ICU setting, to include evaluation of user acceptance, prior to a future definitive trial of effectiveness.
The DELVE system is a new device that has been designed to help improve the management of patients who need a tracheostomy for mechanical ventilation to support their breathing on the ICU. This study will investigate whether the device is feasible to use, and to inform the design of future studies to determine how useful it is.
Dr Charlotte Small