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BACKGROUND: Daily assessment of patient readiness for liberation from invasive mechanical ventilation can reduce the duration of ventilation. However, there is uncertainty about the effectiveness of this in a paediatric population. 
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\nOBJECTIVES: To determine the effect of a ventilation liberation intervention in critically ill children who are anticipated to have a prolonged duration of mechanical ventilation (primary objective) and in all children (secondary objective). 
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\nDESIGN: A pragmatic, stepped-wedge, cluster randomised trial with economic and process evaluations. 
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\nSETTING: Paediatric intensive care units in the UK. 
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\nPARTICIPANTS: Invasively mechanically ventilated children (aged < 16 years). 
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\nINTERVENTIONS: The intervention incorporated co-ordinated multidisciplinary care, patient-relevant sedation plans linked to sedation assessment, assessment of ventilation parameters with a higher than usual trigger for undertaking an…