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PRiVENT 研究:一项具有平行对照组的前瞻性、混合方法干预、多中心研究:研究方案。

Prevention of invasive ventilation (PRiVENT)-a prospective, mixed-methods interventional, multicentre study with a parallel comparison group: study protocol.

机构信息

Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany.

Department of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg, Röntgenstrasse 1, Heidelberg, D-69126, Germany.

出版信息

BMC Health Serv Res. 2023 Mar 30;23(1):305. doi: 10.1186/s12913-023-09283-0.

Abstract

BACKGROUND

Invasive mechanical ventilation (IMV) is a standard therapy for intensive care patients with respiratory failure. With increasing population age and multimorbidity, the number of patients who cannot be weaned from IMV increases, resulting in impaired quality of life and high costs. In addition, human resources are tied up in the care of these patients.

METHODS

The PRiVENT intervention is a prospective, mixed-methods interventional, multicentre study with a parallel comparison group selected from insurance claims data of the health insurer Allgemeine Ortskrankenkasse Baden-Württemberg (AOK-BW) conducted in Baden-Württemberg, Germany, over 24 months. Four weaning centres supervise 40 intensive care units (ICUs), that are responsible for patient recruitment. The primary outcome, successful weaning from IMV, will be evaluated using a mixed logistic regression model. Secondary outcomes will be evaluated using mixed regression models.

DISCUSSION

The overall objective of the PRiVENT project is the evaluation of strategies to prevent long-term IMV. Additional objectives aim to improve weaning expertise in and cooperation with the adjacent Intensive Care Units.

TRIAL REGISTRATION

This study is registered at ClinicalTrials.gov (NCT05260853).

摘要

背景

有创机械通气(IMV)是呼吸衰竭重症监护患者的标准治疗方法。随着人口老龄化和多病共存的增加,无法从 IMV 撤机的患者数量增加,导致生活质量受损和成本高昂。此外,这些患者的护理还需要占用人力资源。

方法

PRiVENT 干预措施是一项前瞻性、混合方法干预、多中心研究,在德国巴登-符腾堡州的健康保险公司 Allgemeine Ortskrankenkasse Baden-Württemberg (AOK-BW) 的保险索赔数据中进行,为期 24 个月,选择了平行比较组。四个撤机中心监督 40 个重症监护病房(ICU),负责患者招募。主要结局是使用混合逻辑回归模型评估从 IMV 成功撤机的情况。次要结局将使用混合回归模型进行评估。

讨论

PRiVENT 项目的总体目标是评估预防长期 IMV 的策略。其他目标旨在提高相邻重症监护病房的撤机专业知识和合作。

试验注册

本研究在 ClinicalTrials.gov 注册(NCT05260853)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62df/10062005/753a05a034b5/12913_2023_9283_Fig1_HTML.jpg

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