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Technology and health care for the elderly medical research studies

Focus on strategic priorities that have significant social impact.

CAT 2013-45

Screening Elderly PatieNts For InclusiOn in a Weaning Trial: The SENIOR Trial

The aim of the trial is to assess metrics that reflect our ability to consent, enroll and recruit elderly and very elderly invasively ventilated patients and evaluate adherence to the study protocols in preparation for conducting a large weaning trial.

Research Results

Project findings and information will be updated on a continual basis.

About the Project

Weaning is the process of transferring the work of breathing from the ventilator back to the patient. Approximately 40% of the total time spent on mechanical ventilation is dedicated to weaning. Research supports that the use of specific strategies to wean patients including the use of daily screening (to identify patients who can breathe spontaneously) and the conduct of tests of patient’s ability to breathe spontaneously to limit the time spent on ventilators and improve outcomes. No randomized trial has evaluated the optimal screening frequency to identify patients to undergo a spontaneous breathing trial (SBT) and no weaning trial has ever been conducted in elderly patients.

The SENIOR Trial will be the first weaning trial conducted in the elderly. This trial is also novel in (1) evaluating our ability to recruit elderly critically ill patients into a mechanical ventilation trial, (2) assessing whether protocols can be adhered to similarily in both study arms and (3) obtaining preliminary estimates of differences in important clinical outcomes between elderly and very elderly participants. This trial will provide valuable information to better inform discussions with elderly, critically ill patients and their SDMs regarding weaning outcomes.

For more details on the project rationale, objectives and research plan, click here.

Project Team

Principal Investigator:

Karen Burns, MD, MSc, FRCPC -- St. Michael's Hospital/University of Toronto

Co-Investigators:

Laurent Brochard, MD -- St. Michael's Hospital

Deborah Cook, MD, MSc -- St. Joseph's Hospital, Hamilton

Peter Dodek, MD, MHSc -- St. Paul's Hospital, Vancouver

Eddy Fan, MD, MPH, BSc -- Toronto General Hospital

Jan Friedrich, MD, MSc, D.Phil, BSc -- St. Michael's Hospital

Lori Hand, RRT -- Hamilton General Hospital

Michelle Kho, PhD, PT -- St. Joseph's Hospital

François Lamontagne, MD, MSc -- Université de Sherbrooke

Maureen Meade, MD, MSc -- McMaster University

Sangeeta Mehta, MD, BSc -- Mount Sinai Hospital, Toronto

Andrew Seely, MD, PhD -- Ottawa General Hospital

Project Contact: Leena Rizvi -- rizvil@smh.ca

CAT 2013-45

Key words: weaning; spontaneous breathing; mechanical ventilation; randomized trial; outcomes