Relation Between the Volume of Subglottic Secretion and Risk of Extubation Failure in ICU Patients
试验速览
- 阶段
- 不适用
- 入组人数
- 300
- 试验地点
- 1
- 主要终点
- Extubation failure
研究概览
简要总结
This study evaluates the relation between the volume of subglottic secretion before airway extubation and the risk of extubation failure in the ICU patient.
详细描述
Between 10 and 20% of patients develop extubation failure (10.7% in our ICU at 2018), which is related to an increased in-hospital death rate, infections, higher costs and longer hospital stays. Tracheal secretions, LVEF<30%, MV > 7d, Weak of cough are identified as risk factors of extubation failures but are not completely performants. Avoiding reintubation remains an important clinical goal.
The subglottic secretion drainage above the cuff of an endotracheal tube is recognized as an effective method to prevent ventilator-associated pneumonia (VAP) in critically ill patients. The subglottic secretion drainage is used in a regular way in our ICU. Volume of subglottic secretion is not analysed in the scientific literature.
Study :
The investigators hypothesize that high volume of subglottic secretion before extubation is associated with high risk of extubation failure and à high risk of pneumonia post extubation.
All planned extubations in the intensive care unit after 2 days minimal of mechanic ventilation are recorded on a designated form and standard variables charted. All data will be collected retrospectively after the extubation event.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •intubated with an orotracheal tube with a subglottic aspiration for more than 24 hours
- •mechanical ventilation for more than 48 hours
- •planned extubations in the intensive care
排除标准
- •age < 18 years
- •terminal extubation
- •Self extubation
- •Pregnancy
结局指标
主要结局
Extubation failure
时间窗: 48 hours
defined as a need for reintubation within 48 h after extubation
Volume of Subglottic Secretion
时间窗: 24 weeks
Quantity (ml) of pre-extubation subglottic secretion during the duration of mechanical
次要结局
- Pneumonia post extubation(7 days)
- Length of stay in ICU(22 month)
- Weaning mechanical ventilation failure(7 days)
- Mortality(28 days)