Page 1/27 Effectiveness of an Expert-Guided Early Tracheostomy Pathway for Mechanically Ventilated Critically Ill Adults in Jordan
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 104
- Locations
- 1
- Primary Endpoint
- Duration of hospitalization from admission to ventilator independent discharge
Study Overview
Brief Summary
The optimal timing of tracheostomy insertion remains uncertain. We hypothesized that a clinical pathway including expert-informed risk assessment regarding predicted duration of mechanical (MV) would enhance the effectiveness of early percutaneous dilatational tracheostomy (PDT) for patients with anticipated prolonged durations of MV, as reflected by duration of ventilation, complications, and patient-centered outcomes.
Detailed Description
three-year prospective observational study (2018-2020) at a tertiary care level 1 trauma center (King Hussein Medical Center) in Amman Jordan and 4 affiliated subspecialty hospitals. The study sequentially enrolled all adult patients (>18yo) with critical illness receiving MV in an intensive care unit for 48 hours or longer. Institutional ethical committee clearance for the study was secured.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients undergoing continued MV for 48 or more hours for whom continuation of life-prolonging therapy was indicated
Exclusion Criteria
- •Patients at imminent risk of death were included
Arms & Interventions
Early Percutaneous dilatational tracheostomy
PDT reccomended for patients with high risk for prolonged mechanical ventilation.
Intervention: Expert-Guided Early Tracheostomy (Other)
Outcomes
Primary Outcomes
Duration of hospitalization from admission to ventilator independent discharge
Time Frame: Hospital stay up to 90 days
Length of stay in days
Secondary Outcomes
- Days of ventilation requiring administration of NMB(Hospital stay up to 90 days)
- Difference in average and total morphine equivalent dose(Hospital stay up to 90 days)
- 90 day survival(90 days)
- Easy or Moderately Easy to Wean(Hospital stay up to 90 days)
Investigators
Ivor Douglas
Professor
Denver Health and Hospital Authority