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Intensive Care UnitGLOBAL WEANNCT04222569

Determination of the Optimal Spontaneous Breathing Trial During Weaning of Mechanical Ventilation

A study testing T-piece, PSV 7 and PEEP 0 and PSV 0 and PEEP 0 in people with Intensive Care Unit and Invasive Mechanical Ventilation, run by University Hospital, Montpellier at 1 site in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Assessment and comparison of three spontaneous breathing trials in five specific profiles of intensive care unit and perioperative patients. A physiological cross over study Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
T-piece, PSV 7 and PEEP 0 and PSV 0 and PEEP 0
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
117 participants
Where
1 siteFrance
Study dates
15 Jun 2020to 15 Jun 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ICU patient with invasive mechanical ventilation for at least 24 hours
  • Physician decision to extubate and all criteria for ventilatory weaning must be present
  • Resolution of disease acute phase for which the patient was intubated
  • Conscious patient (Richmond Agitation-Sedation Scale (RASS) > 0), no sedation
  • Good coughing effort, good swallowing, positive leak test (> 12% of tidal volume (VT))
  • No important secretions
Show all 10Show fewer
  • No respiratory acidosis, adequate oxygenation (PaO2 / FiO2 > 150 mmHg and CPAP ≤ 8)
  • Adequate pulmonary function (respiratory rate (RR) ≤ 35, negative inspiratory force (NIF) > 20 cmH2O, RR/VT < 105)
  • Stable cardiovascular status (heart rate (HR) < 140 bpm, systolic blood pressure > 90 mmHg, no or minimal vasopressors)
  • If severe brain injury, the VISAGE score must be ≥ 3 (visual pursuit, good swallowing, GCS > 10)

Who cannot join

  • Obese patients with BMI ≥ 35 kg/m2
  • Contraindication for nasogastric tube or esophageal manometric balloon placement
  • Refusal of study participation or to pursue the study by the patient, no consent
  • Pregnancy or breastfeeding
  • Absence of coverage by the French statutory healthcare insurance system

Trial locations and contacts

1 site in 1 country.

France1 site
  • Centre Hospitalier Universitaire Saint Eloi

    Montpellier, Herault, 34000

Other trials in France

About this study

Official title: Determination of the Optimal Spontaneous Breathing Trial During Weaning of Mechanical Ventilation: a Randomized and Personalized Cross Over Physiologic Study in the Perioperative and Critically Ill Patient

Assessment and comparison of three spontaneous breathing trials in five specific profiles of intensive care unit and perioperative patients. A physiological cross over study

Read the detailed description

Mechanical ventilation is the most used organ replacement therapy in intensive care unit (ICU). After resolution of acute illness, separating the ventilator from the patient may be specially challenging. Before extubation, it is recommended to perform a spontaneous breathing trial (SBT) to evaluate the ability to sustain breathing with minimal or no support.

The way to carry out this step of the weaning process present important variation across regions of the world. Two techniques are preferentially used : the T-piece trial (oxygen supply without positive pressure) and low pressure support ventilation (PSV) from 6 to 10 cmH2O according to the airway humidification device.

The best strategy for successful weaning remains unknown, especially about specific subgroups of respiratory and neurological diseases.

Our aim is to assess which spontaneous breathing trial would best reproduce post-extubation inspiratory effort. We compare T-piece trial, PSV 7 cmH2O without positive end expiratory pressure (PEEP) and PSV 0 cmH2O without PEEP. Five specific profiles are evaluated : chronic obstructive pulmonary disease (COPD), severe brain injury, blunt thoracic trauma, post abdominal surgery and miscellaneous.

The hypothesis is that T-piece trial and PSV 0 CPAP 0 trial are the best for mimic inspiratory effort after extubation. However, we could highlight various results according to different subgroups of ICU patients. The final aim is to determine a personalized wean trial for each.

Being tested
T-piece, PSV 7 and PEEP 0, PSV 0 and PEEP 0
Keywords
Intensive Care Unit, Critical Care, Mechanical Ventilation Weaning, Spontaneous Breath Trial, Rehabilitation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • T-pieceProcedure or surgery

    Spontaneous breath trial with a T-piece

  • PSV 7 and PEEP 0Procedure or surgery

    Spontaneous breath trial with a pressure support ventilation of 7 cmH2O and no positive end expiratory pressure

  • PSV 0 and PEEP 0Procedure or surgery

    Spontaneous breath trial without pressure support ventilation and positive end expiratory pressure, with a patient intubated and connected to the ventilator

Study groups in NCT04222569
Study groupRoleWhat they receive
T-piece and PSV 7 PEEP 0 and PSV 0 PEEP 0ExperimentalFirst T-piece trial for 15 min. After 10 min of rest, PSV 7 cmH2O and PEEP 0 cmH2O trial for 15 min. After 10 min of rest, PSV 0 cmH2O and PEEP 0 cmH2O trial for 15 min.
Receives: Procedure: T-piece; Procedure: PSV 7 and PEEP 0; Procedure: PSV 0 and PEEP 0
T-piece and PSV 0 PEEP 0 and PSV 7 PEEP 0ExperimentalFirst T-piece trial for 15 min. After 10 min of rest, PSV 0 cmH2O and PEEP 0 cmH2O trial for 15 min. After 10 min of rest, PSV 7 cmH2O and PEEP 0 cmH2O trial for 15 min.
Receives: Procedure: T-piece; Procedure: PSV 7 and PEEP 0; Procedure: PSV 0 and PEEP 0
PSV 0 PEEP 0 and PSV 7 PEEP 0 and T-pieceExperimentalFirst PSV 0 cmH2O and PEEP 0 cmH2O trial for 15 min. After 10 min of rest, PSV 7 cmH2O and PEEP 0 cmH2O trial for 15 min. After 10 min of rest, T-piece trial for 15 min.
Receives: Procedure: T-piece; Procedure: PSV 7 and PEEP 0; Procedure: PSV 0 and PEEP 0
PSV 0 PEEP 0 and T-piece and PSV 7 PEEP 0ExperimentalFirst PSV 0 cmH2O and PEEP 0 cmH2O trial for 15 min. After 10 min of rest, T-piece trial for 15 min. After 10 min of rest, PSV 7 cmH2O and PEEP 0 cmH2O trial for 15 min.
Receives: Procedure: T-piece; Procedure: PSV 7 and PEEP 0; Procedure: PSV 0 and PEEP 0
PSV 7 PEEP 0 and T-piece and PSV 0 PEEP 0ExperimentalFirst PSV 7 cmH2O and PEEP 0 cmH2O trial for 15 min. After 10 min of rest, T-piece trial for 15 min. After 10 min of rest, PSV 0 cmH2O and PEEP 0 cmH2O trial for 15 min.
Receives: Procedure: T-piece; Procedure: PSV 7 and PEEP 0; Procedure: PSV 0 and PEEP 0
PSV 7 PEEP 0 and PSV 0 PEEP 0 and T-pieceExperimentalFirst PSV 7 cmH2O and PEEP 0 cmH2O trial for 15 min. After 10 min of rest, PSV 0 cmH2O and PEEP 0 cmH2O trial for 15 min. After 10 min of rest, T-piece trial for 15 min.
Receives: Procedure: T-piece; Procedure: PSV 7 and PEEP 0; Procedure: PSV 0 and PEEP 0

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Esophageal Pressure Time Product per minute (PTPes.min)

    In cmH2O.s/min. Assessment of patient's inspiratory effort. Integration of esophageal swing pressure over time, performed with a second-generation balloon esophageal catheter, immediately before and after each spontaneous breathing trial, before and 20 min after extubation

    Measured: Day one

Secondary outcomes (2)
  1. Esophageal Pressure Time Product per minute (PTPes.min)

    In cmH2O.s/min. If esophageal catheter still in place, patient's inspiratory effort 24 hours after extubation

    Measured: Day two

  2. Esophageal Pressure Time Product per minute (PTPes.min)

    In cmH2O.s/min. If esophageal catheter still in place, patient's inspiratory effort 48 hours after extubation.

    Measured: Day three

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Jan 2020
  2. Study start15 Jun 2020
  3. Primary completion15 Jun 2023
  4. Study completion15 Jun 2023

Why it stopped: sufficient number of patients to meet objectives

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
Each patient, serving as their own control, realize three SBT for 15 minutes: T-piece, PSV 7 cmH2O without PEEP and PSV 0 cmH2O without PEEP. The order is randomized. The randomization is stratified on pathology. For avoid a carry-over effect, a wash-out period of baseline ventilation for 10 minutes will be respected between trials. The humidification device is a heated humidifier, linked to the ventilator. Data are recorded before (guarantee of real return to baseline) and after each SBT. Then, extubation is decided by clinician in charge, in accordance with guidelines. A 30 min of resting period is respected before. Data are recorded before and 20 minutes after extubation.
Masking
None (open label)
Enrolment
117 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04222569
Sponsor's protocol ID
RECHMPL19_0197
Acronym
GLOBAL WEAN
Status last verified
May 2026
First submitted
9 Dec 2019
Last updated
2 Jun 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual patient data will be made available upon a reasonable request

Publications

  • Mahul M, Jung B, Galia F, Molinari N, de Jong A, Coisel Y, Vaschetto R, Matecki S, Chanques G, Brochard L, Jaber S. Spontaneous breathing trial and post-extubation work of breathing in morbidly obese critically ill patients. Crit Care. 2016 Oct 27;20(1):346. doi: 10.1186/s13054-016-1457-4.

    PubMed 27784322
  • Capdevila M, Aarab Y, Monet C, De Jong A, Vonarb A, Carr J, Molinari N, Capdevila X, Brochard L, Jaber S. Spontaneous breathing trials should be adapted for each patient according to the critical illness. A new individualised approach: the GLOBAL WEAN study. Intensive Care Med. 2024 Dec;50(12):2083-2093. doi: 10.1007/s00134-024-07657-4. Epub 2024 Oct 25.

    PubMed 39453494
  • Capdevila M, De Jong A, Aarab Y, Vonarb A, Carr J, Molinari N, Capdevila X, Brochard L, Jaber S. Which spontaneous breathing trial to predict effort to breathe after extubation according to five critical illnesses: the cross-over GLOBAL WEAN study protocol. BMJ Open. 2023 Jul 12;13(7):e070931. doi: 10.1136/bmjopen-2022-070931.

    PubMed 37438068

Questions about this trial

What is this clinical trial studying?

A study testing T-piece, PSV 7 and PEEP 0 and PSV 0 and PEEP 0 in people with Intensive Care Unit and Invasive Mechanical Ventilation, run by University Hospital, Montpellier at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 2 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: sufficient number of patients to meet objectives). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Esophageal Pressure Time Product per minute (PTPes.min) (time frame: Day one). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04222569, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jun 2026.

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