Comparison of Two Chest Radiograph Prescription Strategies in Intensive Care Unit (RARE)
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Purpose
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.
| Condition |
|---|
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Patient Care Quality of Health Care Intensive Care Units Ventilation, Mechanical |
| Study Type: | Observational |
| Study Design: | Observational Model: Case-Crossover Time Perspective: Prospective |
| Official Title: | A Cluster-Randomized Two-Period Cross-Over Study Comparing Routine and on-Demand Prescription of Chest Radiographs in Mechanically Ventilated Adults : the RARE Study |
- Average number of chest radiographs per patient-day during mechanical ventilation [ Time Frame: Every patient-day during mechanical ventilation. ] [ Designated as safety issue: No ]
- Mortality rate in ICU [ Time Frame: During the inpatient stay in ICU ] [ Designated as safety issue: Yes ]
- Average length of stay [ Time Frame: During the inpatient stay in ICU ] [ Designated as safety issue: No ]
- Average duration of mechanical ventilation [ Time Frame: During the inpatient stay in ICU ] [ Designated as safety issue: No ]
- Number of radiographs with new findings leading to therapeutic or diagnostic interventions [ Time Frame: During the inpatient stay in ICU ] [ Designated as safety issue: No ]
| Enrollment: | 849 |
| Study Start Date: | December 2006 |
| Study Completion Date: | April 2009 |
| Primary Completion Date: | August 2007 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
|
1
Routine strategy of chest radiograph prescription
|
|
2
On-demand strategy of chest radiograph prescription
|
Detailed 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.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
All newly admitted adult patients receiving mechanical ventilation at the time of the morning visit in ICU
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
Contacts and Locations| France | |
| Hopital Saint-Antoine | |
| Paris, France, 75012 | |
| Principal Investigator: | Bertrand GUIDET, MD PhD | Assistance Publique - Hôpitaux de Paris |
More Information
No publications provided by Assistance Publique - Hôpitaux de Paris
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Zakia IDIR, Department Clinical Research of Developpement |
| ClinicalTrials.gov Identifier: | NCT00893672 History of Changes |
| Other Study ID Numbers: | SCR06006 |
| Study First Received: | May 5, 2009 |
| Last Updated: | May 5, 2009 |
| Health Authority: | France: French Data Protection Authority |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
|
Radiography, Thoracic Intensive Care Units Ventilation, mechanical Matched-Pair Analysis |
ClinicalTrials.gov processed this record on May 23, 2013