Endotracheal Tube Securement Study

The Effect of Adhesive Versus Endotracheal Tube Fastener in Critically Ill Adults: The Endotracheal Tube Securement Study

To evaluate the safety and efficacy of endotracheal tube securement techniques, a pragmatic, randomized controlled trial will compare the effect of adhesive tape versus endotracheal tube fastener on complications including lip ulcers, facial skin tears, endotracheal tube dislodgement, and ventilator associated pneumonia among critically ill adults requiring intubation and mechanical ventilation for at least 24 hours.

Background: The optimal securement method of endotracheal tubes is unknown, but should provide adequate security while minimizing complications. This study tests the hypothesis that use of an endotracheal tube fastener would reduce complications among critically ill adults undergoing endotracheal intubation. This hypothesis will be tested in a pragmatic, single center, randomized trial comparing the effect of adhesive tape versus endotracheal tube fastener (Hollister) among critically ill adults requiring intubation and mechanical ventilation for at least 24 hours.

Inclusion Criteria:

• Patient intubated prior to admission to the MICU and the intubation time was less than 12 hours from the time of admission
• Patients intubated in the MICU for greater than 24 hours

Exclusion Criteria:

• intubated greater than 12 hours prior to admission to the MICU
• presence of oral mucosa or facial skin breakdown prior to enrollment
• required nasotracheal intubation,
• had a documented allergy to tape
• pregnant
• prisoners