Chest Trauma
Conditions
Brief summary
The study aims to evaluate the effectiveness of bronchoscopic sputum suction in patients with severe thoracic illness-induced respiratory failure. The study will compare the outcomes of patients who receive bronchoscopic sputum suction versus blind negative pressure aspiration for sputum removal. The study will measure baseline data, postoperative blood gas conditions, and clinical parameters, such as time of invasive ventilation, total time of ventilation, hospital stay, weaning success rate, reintubation rate, ventilator-associated pneumonia incidence, and fatality rate. The study aims to determine whether bronchoscopy-assisted sputum removal is superior to blind negative pressure aspiration in improving patient outcomes.
Detailed description
The aim of the present randomized control trial is to assess the value of bronchoscopic sputum suction in patients with severe thoracic illness-induced respiratory failure. To decrease group differences in baseline characteristics and blood gas conditions, patients will be randomly assigned to receive either bronchoscopy-assisted or negative pressure aspiration for sputum suction, while the remaining treatment course will be the same. The study will measure major clinical indicators such as time of invasive ventilation, total time of ventilation, hospital stay, weaning success rate, reintubation rate, ventilator-associated pneumonia incidence, and fatality rate to provide strong evidence for the efficacy of each suction method.
Interventions
PROCEDUREbronchoscopic sputum suction
Bronchoscopy is a medical procedure in which a flexible tube called a bronchoscope is passed through the mouth or nose and into the lungs. Bronchoscopic suction is a technique used during bronchoscopy to remove secretions, mucus, or foreign objects from the airways. The bronchoscope is equipped with a suction port and a suction channel that allows the doctor to remove fluids or other material from the airways. The suction port is connected to a vacuum source, and the suction channel runs through the bronchoscope and terminates at the tip of the instrument.
PROCEDUREnegative pressure aspiration suction
The procedure involves inserting a catheter into the airway and applying negative pressure to the catheter to suction out the secretions or fluids. The patient could receive sputum suction as medical routine (every 2-4 hrs) if needed.
Sponsors
National Taiwan University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Participants must be 20 years of age or older. * Participants of all genders are eligible. * Participants who are not in good health are not eligible. * Participants with an Injury Severity Score greater than 9 and who have chest trauma are eligible.
Exclusion criteria
* Patients with traumatic brain injury. * Patients with active pulmonary tuberculosis or other respiratory diseases with suspected contagion. * Patients with poor blood clotting function or a tendency to bleed. * Patients with aortic aneurysm. Patients with unstable vital signs or those who cannot maintain oxygen saturation above 90% while performing the test with Fraction of Inspired Oxygen (FiO2) greater than 80% or on 100% oxygen. * Immunocompromised patients. * Patients with acute massive hemoptysis. * Patients with pre-existing neuromuscular diseases or those at high risk for arrhythmias, myocardial ischemia, or pulmonary embolism. * Patients who are unable to clearly express their willingness to sign the informed consent form. * Patients who have frequent intermittent sputum suction or are unable to fast for 4 hours due to their medical condition.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of pneumonia | 30 days after randomization | diagnosis of pneumonia was determined according to radiologic evidence of new or progressive infiltrate of more than 48 hours and laboratory detection of a causative agent. The management and diagnosis of all patients was performed by a trauma specialist. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| intubation rate | 90 days | measure the rate of intubation rate |
| Intensive Care Unit admission interval | 30 days | measure the time of total Intensive Care Unit admission interval |
| admission interval | up to 24 weeks (from randomization to discharge) | measure the time of total admission interval |
| tracheostomy rate | up to 24 weeks (from randomization to discharge) | measure the rate of patient who receive tracheostomy in this admission |
Countries
Taiwan
Outcome results
None listed