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Could stepping down breathing support sooner save more lives?

NCT ID NCT07804992

Disease control Sponsor: Ruijin Hospital Source: ClinicalTrials.gov ↗

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Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing
Running, but no longer taking on new participants.
Completed This study
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Sep 04, 2026 · Last updated Sep 04, 2026

Summary

This study asks whether critically ill adults on ventilators do better if doctors reduce breathing support early, within a day after a 48-hour stability checkpoint, or if they keep support at the same level for longer. Researchers will compare two strategies: early de-escalation, which means moving to a mode where the patient breathes more on their own or removing the breathing tube, versus deferred de-escalation, where support stays the same or increases. The main goal is to see which approach lowers the chance of dying in the hospital within 28 days. The study analyzes data from over 12,000 ICU patients in two large databases to look for patterns that could guide ventilator management.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance
Ventilatory support de-escalation strategy (early step-down from controlled to assisted breathing or extubation, versus deferred maintenance)
What this could lead to
If early de-escalation works, it could guide ICUs to wean patients off ventilators sooner, potentially improving survival and reducing time on breathing machines.
What could go wrong
This is a retrospective analysis of existing records, not a controlled experiment, so it can suggest but not prove a benefit. Early weaning may not suit all patients and could carry risks if done too soon.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Participants

12,736 people

The number who actually took part.

Started

Jan 2024

Finished

Aug 2026

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Who is studied

Adults admitted to the intensive care unit (ICU) receiving invasive mechanical ventilation who are alive and ventilated at the 48-hour landmark with low respiratory support requirements (FiO₂ ≤50%, PEEP ≤10 cmH₂O).

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age ≥18 years * Invasive mechanical ventilation for \>24 hours * Alive and still ventilated at 48 hours after ICU admission * Classifiable Day-2 ventilatory mode (controlled or assisted/spontaneous) * Day-2 FiO₂ ≤50% * Day-2 PEEP ≤10 cmH₂O Exclusion Criteria: * Death during the 24-hour grace period (Day 2 to Day 3) * Unascertainable Day-3 strategy (missing mode without documented ventilation end)

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Conditions

The condition(s) this trial relates to.

Critical Illness respiratory failure

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Critical illness Mechanical ventilation Respiratory failure

Contacts and locations

Locations

  • Department of Critical Care Medicine，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine，Shanghai，China.

    Shanghai, Shanghai Municipality, 200025, China

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