Health Condition 1: - Health Condition 2: J969- Respiratory failure, unspecified
Conditions
Interventions
Intervention1: Cuff leak test result as a part of extubation readiness testing: Quantitative CLT will be performed and cuff leak percentage will be calculated as soon as patient is clinically deemed r
ETT cuff will be deflated, IV dexamethasone 0.5 mg/kg/dose (max 10 mg/dose) q6h upto 4 doses over 24 hours will be administered.
CLT repeated after 24 hours
if pass, patient will be extubated.
Extubation decision beyond second failed CLT at clinician discretion.
Control Intervention1: Extubation readiness testing without using cuff leak test result: Child
Sponsors
AIIMS Raipur
Eligibility
Inclusion criteria
Inclusion criteria: Mechanically ventilated via cuffed endotracheal tube for more than 48 hours and clinically deemed ready for planned extubation.
Exclusion criteria
Exclusion criteria: 1. Pre-existing vocal cord or upper airway anomalies 2. Suspected upper airway trauma or injury 3. Neuromuscular conditions (e.g., pseudobulbar/bulbar palsy) 4. Use of high-dose corticosteroids in prior 72 hours (prednisone more than or equal to 2 mg/kg/day or equivalent) 5. Ongoing pneumothorax with air leak 6. Tracheostomy in place 7. Imminent death or palliative care 8. Prior enrolment in this study 9. Withdrawal or refusal of consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of reintubation or emergency surgical airway with Westley score greater than or equal to 8 with at least 1 point for stridorTimepoint: 72 hours | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of clinically significant PEAO requiring medical interventionTimepoint: 72 hours;Length of PICU stay post-extubationTimepoint: At discharge from PICU;Extra days of invasive mechanical ventilation due to failed CLTTimepoint: At discharge from PICU;Incidence of ventilator associated pneumonia in the extra days of IMV due to failed CLTTimepoint: At discharge from PICU;Predictive value of air leak percentage for incidence of reintubation & clinically significant PEAOTimepoint: Just before extubation;Predictive value of peritubal free space measured by ultrasound for the incidence of reintubation & clinically significant PEAOTimepoint: Just before extubation | — |
Countries
India
Contacts
Public ContactSagar S Kamat
AIIMS Raipur
Outcome results
None listed