Comparison of Two Extubation Techniques in Critically Ill Adult Patients

NCT03918811 · Status: TERMINATED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 725

Last updated 2021-02-09

Study results available
· View outcomes & findings →

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

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT03918811 on ClinicalTrials.gov