Exclusion Criteria

Patients:

• Not assessed on days 1-4 following ICU admission regarding their predicted requirement
• For at least a further 7 days of ventilatory support
• For whom an immediate tracheostomy is required to alleviate upper airway obstruction
• With a tracheal stoma or tracheostomy tube in situ on admission to the ICU
• With chronic hypercarbic (type 2) respiratory failure due to a chronic neurological disease
• Less than 16 years of age
• Previously enrolled in the TracMan trial during the same hospital admission
• Refusing consent or patients in whom consultees do not give agreement
• Who were ‘legally incompetent’ prior to their hospital admission
• Or their relatives who do not understand written or verbal information for whom an Interpreter is not available
• Transferred to your ICU from another ICU