Scoring Method for Describing the Position of a Tracheostomy Tube

NCT ID: NCT01356719

Last Updated: 2020-06-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

20 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-07-31

Study Completion Date

2012-02-29

Brief Summary

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Tracheostomies are artificial airway devices inserted into the neck. They can become displaced and lead to patient harm. Other than external visual inspection, there is no currently described system for describing the position of a tracheostomy tube within the airway. The investigators propose to undertake endoscopic inspection of the tracheostomy tube with a small fibre-optic camera from above and also through the tube to visualise its position within the airway. The investigators will take anonymised paired images and then score these using 6 different scoring systems. The investigators will determine which scoring system provides the simplest and most reproducible scores between 6 blinded assessors. A clinically useful scoring system could be used in future to predict problems with tracheostomy positioning.

Detailed Description

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Aims \& Outcomes

1. Develop an appropriate bedside scoring method for describing the position and orientation of a tracheostomy tube tip when viewed endoscopically from a standardised position
2. Secondary aims

* Correlate the endoscopic views of the tracheostomy tube with the trans-laryngeal views.
* Is it possible to predict the trans-laryngeal view from the endoscopic view.
* Does the position of a tracheostomy tube tip change when the patient is repositioned following percutaneous tracheostomy (when viewed endoscopically)
* Equipment training: Compare the number of supervised endoscopies required to consistently achieve the required standardised view
3. Primary outcome

\- Determine the scoring system with the best inter-rater agreement as defined by weighted kappa and intra-class correlation coefficients.
4. Secondary outcome

\- Assess correlation between the best scoring system (chosen by above) with the translaryngeal view
5. Tertiary aim - Assessment of training: Determine the number of attempts required to obtain adequate standardised views. This will be a manikin based assessment to demonstrate competence in performing the endoscopies for the study before any procedures are undertaken on patients.

Conditions

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Tracheostomy

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Adults \>16 years old
* Presence of a percutaneous or surgical tracheostomy
* Patient being cared for in the AICU of UHSM

Exclusion Criteria

* Endoscopy not clinically appropriate (in the opinion of the attending physician)
* Refusal by patient or their representative
Minimum Eligible Age

16 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Manchester University NHS Foundation Trust

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Brendan A McGrath, MB ChB

Role: PRINCIPAL_INVESTIGATOR

University Hospital of South Manchester

Locations

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University Hospital of South Manchester

Manchester, , United Kingdom

Site Status

Countries

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United Kingdom

References

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McGrath BA, Lynch K, Templeton R, Webster K, Simpson W, Alexander P, Columb MO. Assessment of scoring systems to describe the position of tracheostomy tubes within the airway - the lunar study. Br J Anaesth. 2017 Jan;118(1):132-138. doi: 10.1093/bja/aew336.

Reference Type DERIVED
PMID: 28039250 (View on PubMed)

Related Links

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Other Identifiers

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LUNAR2011

Identifier Type: -

Identifier Source: org_study_id

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