Tracheostomy Weaning
Conditions
Brief summary
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.
Interventions
PROCEDURESuctioning based protocol
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.
PROCEDUREUsual Care
Usual care in our center is tolerance to a capping trial.
Sponsors
Université de Sherbrooke
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
None, patients and physicians will know the protocol
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Weaning from mechanical ventilation for at least 24 hours * Randomisation must be done in 24 hours of the mechanical ventilation weaning.
Exclusion criteria
* Sabadell \> 2 * Contraindication of decannulation : Glasgow Coma Scale \<6, severe dysphagia, non permeable respiratory tracks, neuromuscular disease (expect for the ICU weakness) and long term tracheostomy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to 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. | Time between the randomisation and the decannulation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of stay ICU | From admission to the date when the patient quit the ICU, through study completion, average of 6 to 12 months. | Lenght of stay in the ICU. |
| Length of stay hospital | From admission to the date when the patient is discharge of the hospital, through study completion, average of 6 to 12 months. | Length of stay in the hospital |
| ICU readmission | Through study completion, average of 6 to 12 months. | ICU readmission |
| Time to decannulation criteria | 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. | Time between the randomisation and the criteria of decannulation |
| Mechanical Ventilation weaning failure | Through study completion, average of 6 to 12 months. | Necessity of starting mechanical ventilation once the randomisation is started |
| Adverses effects | Through study completion, average of 6 to 12 months. | Pneumonia, sepsis, septic shock |
| Mortality | Through study completion, average of 6 to 12 months. | All cause mortality |
| Decannulation failure | Through study completion, average of 6 to 12 months. | Necessity of reimplantation of a tracheostomy after the decannulation |
Countries
Canada
Outcome results
None listed