CDC Prevention Epicenters Wake Up and Breathe Collaborative

Summary

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.

Conditions

• Ventilator-associated Pneumonia

Interventions

PROCEDURE

Daily SAT & SBT

Nurse and/or respiratory therapist led daily awakenings from sedation (spontaneous awakening trial, or SAT) and daily performance of a spontaneous breathing trial (SBT) among mechanically ventilated, critically ill patients in participating ICUs.

Sponsors & Collaborators

• Centers for Disease Control and Prevention

  collaborator FED

• Washington University School of Medicine

  collaborator OTHER

• Rush University Medical Center

  collaborator OTHER

• University of Pennsylvania

  collaborator OTHER

• Duke University

  collaborator OTHER

• North Shore Medical Center

  collaborator OTHER

• Harvard Pilgrim Health Care

  lead OTHER

Principal Investigators

• Michael Klompas, MD, MPH · Harvard Pilgrim Health Care

Study Design

Allocation

NA

Purpose

TREATMENT

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2012-05-31

Primary Completion

2013-06-30

Completion

2013-10-31

Countries

• United States

Study Locations