Comparison of Two Extubation Techniques in Critically Ill Adult Patients
NCT03918811 · Status: TERMINATED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 725
Last updated 2021-02-09
Summary
Orotracheal extubation consists in the removal of the endotracheal tube (ETT) when it is no longer required. This procedure may carry a considerable risk of complications and extubation failure. The literature points out two methods of extubation: the traditional method and the positive pressure method.
In a noninferiority clinical trial it was demonstrated that EOT with positive pressure and without endotracheal suction was a safe technique and could be better than traditional extubation. Although prior studies reported better clinical outcomes with the positive pressure extubation technique, its superiority has not been deeply studied yet. Therefore, the objective of our study is to determine whether the positive pressure OTE technique, compared with the traditional OTE technique, reduces the incidence of major postextubation complications (up to 60 minutes) in critically ill adult patients.
Conditions
- Weaning Failure
- Mechanical Ventilation Complication
Interventions
- PROCEDURE
-
Positive Pressure Extubation Technique
Positive-pressure extubation is performed by only one operator. Ventilator parameters are set to pressure support ventilation mode, with an inspiratory pressure of 15 cm H2O and PEEP of 10 cm H2O. Then, the cuff is deflated, and the ETT is removed without endotracheal suction. Once the ETT is removed, a suction catheter is introduced through the mouth to suction secretions drawn to the oropharynx by the air flow from the ventilator passing between the ETT and the larynx.
- PROCEDURE
-
Traditional Extubation Technique
Traditional extubation is performed by 2 operators. Without reconnection to the ventilator, the closed suction system catheter is introduced by one of the operators into the ETT and suctioning is initiated. The cuff is immediately deflated by the other operator, and the ETT is removed with continuous endotracheal suction during the whole procedure by the first operator.
Sponsors & Collaborators
-
Matías Bertozzi
collaborator UNKNOWN -
Marco Bezzi
collaborator UNKNOWN -
Borello, Silvina, M.D.
collaborator INDIV -
Daniela Castro
collaborator UNKNOWN -
Victoria Di Giorgio
collaborator UNKNOWN -
Mariana Aguirre
collaborator UNKNOWN -
Karina Miralles
collaborator UNKNOWN -
Diego Noval
collaborator UNKNOWN -
Sebastián Fredes
collaborator UNKNOWN -
Eliana Wilhelm
collaborator AMBIG -
Mauricio Zakimchuk
collaborator UNKNOWN -
Julián Buffarini Cignoli
collaborator UNKNOWN -
Mariana Bernardini
collaborator UNKNOWN -
Leticia Rey
collaborator UNKNOWN -
Valeria Pieroni
collaborator UNKNOWN -
Pablo D´Annunzio
collaborator UNKNOWN -
Gustavo Plotnikow
collaborator UNKNOWN -
Romina Prato
collaborator UNKNOWN -
Matías Lompizano
collaborator UNKNOWN -
María Guaymas
collaborator UNKNOWN -
Matías Accoce
collaborator UNKNOWN -
Javier Dorado
collaborator UNKNOWN -
Gimena Cardoso
collaborator UNKNOWN -
Patricia Torres
collaborator UNKNOWN -
Vanesa Pavlotsky
collaborator UNKNOWN -
Emiliano Navarro
collaborator AMBIG -
Eliana Markman
collaborator AMBIG -
Paula Di Nardo
collaborator UNKNOWN -
Ivonne Kunzi Steyer
collaborator UNKNOWN -
Thomsen, Carolina, M.D.
collaborator INDIV -
Cecilia Palacios
collaborator UNKNOWN -
Mariela Davies
collaborator UNKNOWN -
Mercedes Ruffo
collaborator UNKNOWN -
Victoria Leon
collaborator UNKNOWN -
Fernando Tapia
collaborator UNKNOWN -
Hospital Donación Francisco Santojanni
lead OTHER
Principal Investigators
-
Mauro F Andreu, Prof · Hospital Santojanni
Study Design
- Allocation
- RANDOMIZED
- Purpose
- TREATMENT
- Masking
- DOUBLE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2019-04-01
- Primary Completion
- 2020-03-26
- Completion
- 2020-03-26
Countries
- Argentina
Study Locations
More Related Trials
-
Association Between P0.1 and Extubation Failure in Adult Patients with Acute Hypoxemic Respiratory Failure. a Multicenter Prospective Cohort Study
NCT06662201 ·Status: ACTIVE_NOT_RECRUITING
-
Monitoring of Breathing Effort Through Pressure Time Product Measurement Using Airway Occlusion Pressure
NCT06040138 ·Status: RECRUITING
-
One-Hour Positive Pressure Ventilation After a T-Piece Spontaneous Breathing Trial
NCT07324382 ·Status: NOT_YET_RECRUITING ·Phase: NA
-
Maximum Expiratory Pressure in Induced Cough as a Predictor of Extubation Failure
NCT04356625 ·Status: COMPLETED ·Phase: NA
-
Pressure Support and Positive End Expiratory Pressure During Spontaneous Breathing Trial
NCT03861117 ·Status: COMPLETED ·Phase: NA
-
Prevention of Reintubation by Using Noninvasive Positive Pressure Ventilation
NCT00977002 ·Status: UNKNOWN ·Phase: PHASE3
-
High-flow Conditioned Oxygen Therapy Versus Non-invasive Ventilation: Prevention of Post-extubation Failure
NCT01191489 ·Status: COMPLETED ·Phase: PHASE3
-
Ventilatory Settings and Monitoring Variables Associated With Weaning Failure in Critically Ill Patients
NCT06683781 ·Status: RECRUITING
-
Protective Manual Hyperinflation in Acute Mechanically Ventilated Trauma Patients
NCT01366274 ·Status: UNKNOWN ·Phase: NA
-
Direct Extubation Versus Extubation After a Spontaneous Breathing Trial in Patients at Low Risk of Extubation Failure
NCT07019636 ·Status: NOT_YET_RECRUITING ·Phase: NA
-
Ventilation Strategies During Spontaneous Breathing Trial
NCT02939963 ·Status: COMPLETED ·Phase: NA
-
Proportional Assist Ventilation Plus and Estimation of Respiratory Effort During the Transition to Spontaneous Ventilation
NCT06998927 ·Status: ACTIVE_NOT_RECRUITING
-
Lung Volume Preservation During Extubation
NCT05526053 ·Status: COMPLETED ·Phase: NA
-
Non-invasive Ventilation vs Oxygen Therapy After Extubation Failure
NCT03832387 ·Status: COMPLETED ·Phase: NA
-
Characterization of Weaning Practices in ICUs of Global South Countries
NCT07337408 ·Status: NOT_YET_RECRUITING
-
A New Tool for Extubation Readiness in Mechanically Ventilated Patients: Readiness for EXtubation Score
NCT07098611 ·Status: RECRUITING
-
Association Between Tidal Volume and Mortality in Pressure Support in Adults Under Invasive Mechanical Ventilation
NCT06195475 ·Status: COMPLETED
-
High Flow Nasal Cannula in Immediately Post Extubation
NCT03495947 ·Status: COMPLETED
-
Non-invasive Ventilation Following Extubation (Prophylactic) to Prevent Extubation Failure in Critically Obese Patients
NCT04014920 ·Status: COMPLETED ·Phase: NA
-
Extubation Failure Prevention in High Risk Patients by High-flow Conditioned Oxygen Therapy vs. Standard Oxygen Therapy
NCT01820507 ·Status: TERMINATED ·Phase: NA
-
Effect of High-Flow Tracheal Oxygen on EELI
NCT06824220 ·Status: ACTIVE_NOT_RECRUITING ·Phase: NA
-
Global Physiotherapy in ICU Patients With High Risk Extubation Failure
NCT05423301 ·Status: COMPLETED ·Phase: NA
-
Non-Positive Pressure Ventilation in Hypoxemic Patients
NCT00925860 ·Status: COMPLETED ·Phase: PHASE4
-
Extubation Advisor: Initial Implementation and Evaluation of a Novel Extubation Clinical Decision Support Tool
NCT04708509 ·Status: COMPLETED ·Phase: PHASE1
-
Early Occupational Therapy in Mechanical Ventilated Patients With Covid-19
NCT04904497 ·Status: UNKNOWN ·Phase: NA