Research on Respiratory Support Decision-Making for Mechanically Ventilated ICU Patients Based on a Physiological World Model

NCT07834671 | Not Yet Recruiting

• 1 other identifier: RJ2026681
• Study Type: observational
• Target: 4,232
• Locations: 1 country
• Sites: 1

Brief Summary

Mechanical ventilation is essential for ICU patients with respiratory failure, yet ventilator adjustment and weaning decisions remain experience-dependent and highly variable. Current single-point metrics such as the oxygenation index cannot distinguish true recovery from support-dependent stability-the same oxygenation level may reflect either. This study uses EHR data from 4,232 invasively ventilated ICU patients at Ruijin Hospital (2016-2026) to develop LAVENT, a deep learning-based physiological world model of respiratory dynamics. LAVENT learns the co-evolution of patient physiology and respiratory support, generates 96-hour multivariate trajectories under candidate FiO₂/PEEP settings, and compares alternative ventilation strategies within the same patient state. External validation uses the MIMIC-IV database (n = 29,899). This retrospective observational study uses only existing EHR data, with no prospective intervention or biospecimen collection.

Conditions

Acute Respiratory Failure

Keywords

ventilator weaning; mechanical ventilation

Outcome Measures

Primary Outcomes (1)

• success rate of ventilator weaning

  The proportion of participants who successfully achieve liberation from invasive mechanical ventilation (weaning success), expressed as a percentage of all participants who undergo a weaning attempt

  28 days

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult ICU patients (≥18 years) who received invasive mechanical ventilation at the Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, between January 2016 and June 2026.

You may qualify if:

• age ≥ 18 years
• received invasive mechanical ventilation during ICU stay
• had complete 48hour baseline data and 96hour followup data.

You may not qualify if:

• age \< 18 years
• duration of mechanical ventilation \< 24 hours
• missing rate \> 50% for key variables (FiO₂, PEEP, SpO₂, respiratory rate)
• received ECMO therapy.

Sponsors & Collaborators

• Ruijin Hospital: lead

Study Sites (1)

Ruijin hospital

Shanghai, Shanghai Municipality, 200025, China

Location

Central Study Contacts

Jing Xu

CONTACT

+8618217732985; xj40952@rjh.com.cn

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Chief Physician

Study Record Dates

• First Submitted: September 10, 2026
• First Posted: September 22, 2026
• Study Start: September 14, 2026
• Primary Completion (Estimated): December 31, 2028
• Study Completion (Estimated): December 31, 2029
• Last Updated: September 22, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)