Tracheostomy in ICU With a Double Lumen Endotracheal Tube

NCT ID: NCT01691222

Last Updated: 2013-07-03

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-07-31

Study Completion Date

2015-06-30

Brief Summary

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Percutaneous tracheostomy in Intensive care unit (ICU) is performed with the use of flexible fiberoptic bronchoscope inside the conventional single lumen endotracheal tube owned by the patients. This situation may lead to many disadvantages for ventilation and airway protection of critically ill patients during the procedures. The use of double lumen endotracheal tube dedicated to the percutaneous tracheostomies may:

1. improve the ventilation of patients during the procedure,
2. protect the posterior tracheal wall from damage related to the different step of tracheostomies,
3. protect the lungs from blood and secretions coming down from the chosen site of tracheostomy.

So the aim of this study is to evaluate the oxygenation, gas exchange, ventilation and complications of percutaneous tracheostomies performed in ICU with a dedicated double lumen endotracheal tube.

Detailed Description

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Conditions

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Acute Respiratory Failure Heart Failure Neurological Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Blinding Strategy

NONE

Study Groups

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Double lumen endotracheal tube tracheostomy

Tracheostomy with a dedicated double lumen endotracheal tube

Group Type OTHER

Double lumen endotracheal tube tracheostomy

Intervention Type DEVICE

Percutaneous tracheostomy in this study will be performed with the use of a dedicated double-lumen endotracheal tube.

The dedicated double-lumen endotracheal tube (Deas S.R.L, Italy) has an upper and a lower lumen. The upper one will be occupied by flexible fiberoptic bronchoscope while the lower one is exclusively dedicated to patient ventilation during the procedure. The lower lumen has a a semi-elliptical cross section. This tube will be placed in the patient airway with a direct laryngoscopy. After this intubation, a percutaneous dilatational tracheostomy will be performed with the standard techniques recognised in the literature.

Interventions

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Double lumen endotracheal tube tracheostomy

Percutaneous tracheostomy in this study will be performed with the use of a dedicated double-lumen endotracheal tube.

The dedicated double-lumen endotracheal tube (Deas S.R.L, Italy) has an upper and a lower lumen. The upper one will be occupied by flexible fiberoptic bronchoscope while the lower one is exclusively dedicated to patient ventilation during the procedure. The lower lumen has a a semi-elliptical cross section. This tube will be placed in the patient airway with a direct laryngoscopy. After this intubation, a percutaneous dilatational tracheostomy will be performed with the standard techniques recognised in the literature.

Intervention Type DEVICE

Other Intervention Names

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International Patent n° PCT/IT2012/000154

Eligibility Criteria

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Inclusion Criteria

* age ≥ 18 years and at least one of following criteria:
* prolonged endotracheal intubation
* prolonged mechanical ventilation
* difficult/prolonged weaning
* inability to protect the airway

Exclusion Criteria

* infection of neck tissues
* previous surgical neck interventions
* recent surgical interventions or fracture of the cervical spine
Minimum Eligible Age

18 Years

Maximum Eligible Age

82 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Genova

OTHER

Sponsor Role lead

Responsible Party

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Paolo Pelosi

Full Professor chair of Anesthesiology and Intensive Care Medicine. Chief of Intensive Care Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Paolo Pelosi, Professor

Role: STUDY_DIRECTOR

Universita degli Studi di Genova

Giuseppe Servillo, Professor

Role: STUDY_DIRECTOR

Federico II University

Locations

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University of Genoa

Genoa, Italy, Italy

Site Status RECRUITING

University of Naples "Federico II"

Naples, Italy, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Paolo Pelosi, Professor

Role: CONTACT

+39 010 555 3136

Facility Contacts

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Paolo Pelosi, Professor

Role: primary

+ 39 0101 5553136

Giuseppe Servillo, Professor

Role: primary

+39 081 7463552

References

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Rana S, Pendem S, Pogodzinski MS, Hubmayr RD, Gajic O. Tracheostomy in critically ill patients. Mayo Clin Proc. 2005 Dec;80(12):1632-8. doi: 10.4065/80.12.1632.

Reference Type BACKGROUND
PMID: 16342657 (View on PubMed)

De Leyn P, Bedert L, Delcroix M, Depuydt P, Lauwers G, Sokolov Y, Van Meerhaeghe A, Van Schil P; Belgian Association of Pneumology and Belgian Association of Cardiothoracic Surgery. Tracheotomy: clinical review and guidelines. Eur J Cardiothorac Surg. 2007 Sep;32(3):412-21. doi: 10.1016/j.ejcts.2007.05.018. Epub 2007 Jun 27.

Reference Type BACKGROUND
PMID: 17588767 (View on PubMed)

King C, Moores LK. Controversies in mechanical ventilation: when should a tracheotomy be placed? Clin Chest Med. 2008 Jun;29(2):253-63, vi. doi: 10.1016/j.ccm.2008.01.002.

Reference Type BACKGROUND
PMID: 18440435 (View on PubMed)

Durbin CG Jr. Tracheostomy: why, when, and how? Respir Care. 2010 Aug;55(8):1056-68.

Reference Type BACKGROUND
PMID: 20667153 (View on PubMed)

Mallick A, Bodenham AR. Tracheostomy in critically ill patients. Eur J Anaesthesiol. 2010 Aug;27(8):676-82. doi: 10.1097/EJA.0b013e32833b1ba0.

Reference Type BACKGROUND
PMID: 20523214 (View on PubMed)

Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. Chest. 1985 Jun;87(6):715-9. doi: 10.1378/chest.87.6.715.

Reference Type BACKGROUND
PMID: 3996056 (View on PubMed)

Fantoni A, Ripamonti D. A non-derivative, non-surgical tracheostomy: the translaryngeal method. Intensive Care Med. 1997 Apr;23(4):386-92. doi: 10.1007/s001340050345.

Reference Type BACKGROUND
PMID: 9142576 (View on PubMed)

Griggs WM, Worthley LI, Gilligan JE, Thomas PD, Myburg JA. A simple percutaneous tracheostomy technique. Surg Gynecol Obstet. 1990 Jun;170(6):543-5.

Reference Type BACKGROUND
PMID: 2343371 (View on PubMed)

Trottier SJ, Hazard PB, Sakabu SA, Levine JH, Troop BR, Thompson JA, McNary R. Posterior tracheal wall perforation during percutaneous dilational tracheostomy: an investigation into its mechanism and prevention. Chest. 1999 May;115(5):1383-9. doi: 10.1378/chest.115.5.1383.

Reference Type BACKGROUND
PMID: 10334157 (View on PubMed)

Campos JH. Update on tracheobronchial anatomy and flexible fiberoptic bronchoscopy in thoracic anesthesia. Curr Opin Anaesthesiol. 2009 Feb;22(1):4-10. doi: 10.1097/ACO.0b013e32831a43ab.

Reference Type BACKGROUND
PMID: 19295287 (View on PubMed)

Vargas M, Pelosi P, Tessitore G, Aloj F, Brunetti I, Arditi E, Salami D, Kacmarek RM, Servillo G. Percutaneous dilatational tracheostomy with a double-lumen endotracheal tube: a comparison of feasibility, gas exchange, and airway pressures. Chest. 2015 May;147(5):1267-1274. doi: 10.1378/chest.14-1465.

Reference Type DERIVED
PMID: 25375865 (View on PubMed)

Other Identifiers

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90/12

Identifier Type: -

Identifier Source: org_study_id

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