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Optimising time-limited trials in acute respiratory failure: a multicentre focused ethnography protocol
Jacqueline M Kruser1, Douglas A Wiegmann2, Nandita R Nadig3
1Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA jkruser@wisc.edu.
BMJ Open
|December 15, 2025
Summary
This study characterizes optimal time-limited trials for critical illness, aiming to standardize their use in intensive care units (ICUs). Findings will guide clinicians in decision-making for life-sustaining therapies.
Area of Science:
- Critical Care Medicine
- Palliative Care
- Medical Ethics
Background:
- Time-limited trials (TLTs) are collaborative plans for life-sustaining therapies in critical illness.
- TLTs define a duration for therapy, after which decisions are made about continuing or transitioning care.
- Despite widespread use, evidence guiding TLT conduct is limited, leading to practice variations.
Purpose of the Study:
- To characterize the features of an optimal time-limited trial.
- To understand how TLTs shape critical care delivery.
- To reduce variation in the application of TLTs.
Main Methods:
- Observational, multicentre, focused ethnography of TLTs.
- Study population: patients with acute respiratory failure on mechanical ventilation, surrogate decision-makers, and ICU clinicians.
- Dual analysis using constructivist grounded theory and systems engineering.
Main Results:
- (Study in progress - results pending dissemination)
- (Study in progress - results pending dissemination)
- (Study in progress - results pending dissemination)
Conclusions:
- (Study in progress - conclusions pending dissemination)
- (Study in progress - conclusions pending dissemination)
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