A major UK clinical trial has shown how a new approach to reduce the use of mechanical ventilation can greatly improve outcomes for critically ill infants and children.
The study was co-led by the University of Leeds and took place in several UK hospitals including Leeds General Infirmary.
It found that a greater involvement of nurses, minimising sedation use and increasing daily testing to assess the child’s readiness to come off the ventilator significantly reduced the time on mechanical ventilation.
It is the largest trial of its kind and has already led to changes in practice for two-thirds of the UK paediatric intensive care units (PICUs) for the benefit of infants and children.
Compared to the current standard care, the study reported that in children who were expected to be on a ventilator for more than 24 hours, the intervention reduced the time on the mechanical ventilator by an average of six hours. Furthermore, in all children regardless if they were expected to be on a ventilator for more or less than 24 hours, the intervention reduced the ventilation time by an average of seven hours. Overall, the chances of children having their breathing tube removed successfully was greater.
The Sedation AND Weaning In CHildren (SANDWICH) trial is the world’s largest trial recruiting infants and children in PICUs. The study involved more than 10,000 admissions to 18 ICUs, accounting for two-thirds of the UK’s PICUs.