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In the DECAP-ICU trial, the investigators will be focusing on the impact of a new weaning tracheostomy technique based on suctioning frequency compared to the standard practice of capping tolerance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Suction based protocol | Experimental | Weaning protocol based on suctioning frequency. Once the weaning of mechanical ventilation, the patients in this arm will be on high-flow nasal canula. The canula will be remove if the decannulation conditions are met (if the patient require less than 2 aspirations in 8 hours for 24 consecutive hours) |
|
| Usual care | Other | Usual care will mainly base on the capping trial. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Suctioning based protocol | Procedure | cf. arm The necessity of suctioning will be assed continuously by the nurses, respiratory therapist and the medical team. If the patient require 2 or less aspiration each 8 hours for 24 hours straight, an attempt of decanalution will be done. |
| Measure | Description | Time Frame |
|---|---|---|
| Time to decannulation | Time between the randomisation and the decannulation | Frome date of randomisation to the date of the actual decannulation or to the date of death, whichever comes first, assessed up to 48 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Time to decannulation criteria | Time between the randomisation and the criteria of decannulation | From date of randomisation to the date when the criteria of decannulation are met or to the date of death, whichever comes first, assessed up to 48 months. |
| Length of stay ICU |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Université de Sherbrooke | Sherbrooke | Quebec | J1H 5H3 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30115127 | Background | Abe T, Madotto F, Pham T, Nagata I, Uchida M, Tamiya N, Kurahashi K, Bellani G, Laffey JG; LUNG-SAFE Investigators and the ESICM Trials Group. Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries. Crit Care. 2018 Aug 17;22(1):195. doi: 10.1186/s13054-018-2126-6. | |
| 26635016 |
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None, patients and physicians will know the protocol
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|
| Usual Care | Procedure | Usual care in our center is tolerance to a capping trial. |
|
Lenght of stay in the ICU. |
| From admission to the date when the patient quit the ICU, through study completion, average of 6 to 12 months. |
| Length of stay hospital | Length of stay in the hospital | From admission to the date when the patient is discharge of the hospital, through study completion, average of 6 to 12 months. |
| ICU readmission | ICU readmission | Through study completion, average of 6 to 12 months. |
| Decannulation failure | Necessity of reimplantation of a tracheostomy after the decannulation | Through study completion, average of 6 to 12 months. |
| Mechanical Ventilation weaning failure | Necessity of starting mechanical ventilation once the randomisation is started | Through study completion, average of 6 to 12 months. |
| Adverses effects | Pneumonia, sepsis, septic shock | Through study completion, average of 6 to 12 months. |
| Mortality | All cause mortality | Through study completion, average of 6 to 12 months. |
| Hosokawa K, Nishimura M, Egi M, Vincent JL. Timing of tracheotomy in ICU patients: a systematic review of randomized controlled trials. Crit Care. 2015 Dec 4;19:424. doi: 10.1186/s13054-015-1138-8. |
| 27842753 | Background | Mahmood K, Wahidi MM. The Changing Role for Tracheostomy in Patients Requiring Mechanical Ventilation. Clin Chest Med. 2016 Dec;37(4):741-751. doi: 10.1016/j.ccm.2016.07.013. Epub 2016 Oct 14. |
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