Clinical and Economic Comparison of 2 Methods of Intubation Tube Fixation : AnchorFastTM Versus Current Cord Fixation

NCT ID: NCT06533436

Last Updated: 2025-02-12

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

RECRUITING

Clinical Phase

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-02

Study Completion Date

2026-12-02

Brief Summary

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The aim of this study is to assess the benefits of using the Anchorfast device in reducing complications associated with intubation tube fixation, in terms of the rate of pressure ulcer development, the rate of intubation tube mobilization and the rate of VAP occurrence. If the hypothesis is confirmed, this project would enable the caregivers to optimize the current practice in the interests of both patients and caregivers. That's why the investigators have designed a real-life study, and will also be looking at the effect of care load on and caregiver satisfaction.

Detailed Description

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In 2022 at Hôpital FOCH, 41% of patients admitted to the intensive care unit required an orotracheal intubation tube (OIT), exposing them to the risk of developing orotracheal intubation tube (OIT), exposing them to the risk of developing ventilator-associated pneumonia (VAP).

Preventing VAP involves oral hygiene and limiting tube movements, which depend on the device used to attach the OIT . The care protocol used routinely in the department uses adhesive tape and a rigid cotton haberdashery cord. This type of fixation impedes buccal access, prevents easy repositioning of the probe and is liable to cause eschar lesions.

With the aim of improving the practices, the investigators took a closer look at the French recommendations. The Société de Réanimation de Langue Française (French Intensive Care Society) does not recommend a particular fixation method, but it does relay publications that shows the superiority of the AnchorfastTM device over adhesive tape fixation in terms of the incidence of pressure sores and accidental catheter mobilization.

The aim of this study is to assess the benefits of using the Anchorfast device in reducing complications associated with intubation tube fixation, in terms of the rate of pressure ulcer development, the rate of intubation tube mobilization and the rate of VAP occurrence. If the hypothesis is confirmed, this project would enable the caregivers to optimize the current practice in the interests of both patients and caregivers. That's why the investigators have designed a real-life study, and will also be looking at the effect of care load on and caregiver satisfaction.

Conditions

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Intubation Complication Eschar

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

A total of 170 patients will be included over two distinct 6-month periods (85 patients per period). Each period corresponds to the study of one fixation device: cord fixation or fixation with the AnchorFastTM medical device.

The caregivers will also be included as a population since the workload with the two types of device will be evaluated and compared.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Cord attachement

Caregivers follow the Tensoplast® white cord and elastic plaster fixation protocol, which has been revised and validated by the care department.

Tube care is carried out in two stages: preparing the patient for the procedure (safety and hygiene) then renewal of the fixation device.

Group Type ACTIVE_COMPARATOR

Corded tube care

Intervention Type PROCEDURE

The caregiver cut a 6 cm strip of Tensoplast® and wrapped it around the intubation probe at the level of the prescribed fixation mark at the corner of the mouth. The cord strands are placed around the patient's head, tightened, and a double knot is tied at the patient's cheek. Compresses are placed over the ears to protect them from possible lesions caused by the cords.

AnchorFast

The AnchorFastTM fixation device developed by Laboratoire Hollister is a single-use medical device. This fixation system consists of a hard plastic guide on which the intubation tube can slide laterally.

It facilitate access to the oral cavity and limit pressure points on the corners of the mouth.

Group Type EXPERIMENTAL

Tube care attached by AnchorFast

Intervention Type DEVICE

Shaving is recommended for patients with beards, and prior family consent is required for patients with beards.

AnchorFast is Suitable for intubation probes from 5 to 10 mm in diameter, it adapts to different morphologies thanks to hydrocolloid dressings bonded to the face and an adjustable cord around the neck. Due to its rigidity, this device is not recommended for patients whose condition requires them to be positioned in the ventral decubitus (VD) or lateral decubitus position.

Caregivers

The caregivers will be included as a study population. Caregivers will conduct the search for the other two arms (ancofast and by cord) and then fill in questionnaires assessing the workload and comfort of tube care.

Group Type OTHER

Caregiver's evaluation on each tube fixation

Intervention Type OTHER

The caregivers who performs the interventions according to the study will fill question form to assess the worload and the confort of the tube care for each intervention type The caregivers are both a research actor and a study population. One of the secondary aims of this study is to evaluate the two types of tube-fixing with regard to caregiver workload and comfort in performing care. Caregivers will complete identical questionnaires assessing their satisfaction with the two types of tube fixation studied in arms 1 and 2.

Interventions

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Corded tube care

The caregiver cut a 6 cm strip of Tensoplast® and wrapped it around the intubation probe at the level of the prescribed fixation mark at the corner of the mouth. The cord strands are placed around the patient's head, tightened, and a double knot is tied at the patient's cheek. Compresses are placed over the ears to protect them from possible lesions caused by the cords.

Intervention Type PROCEDURE

Tube care attached by AnchorFast

Shaving is recommended for patients with beards, and prior family consent is required for patients with beards.

AnchorFast is Suitable for intubation probes from 5 to 10 mm in diameter, it adapts to different morphologies thanks to hydrocolloid dressings bonded to the face and an adjustable cord around the neck. Due to its rigidity, this device is not recommended for patients whose condition requires them to be positioned in the ventral decubitus (VD) or lateral decubitus position.

Intervention Type DEVICE

Caregiver's evaluation on each tube fixation

The caregivers who performs the interventions according to the study will fill question form to assess the worload and the confort of the tube care for each intervention type The caregivers are both a research actor and a study population. One of the secondary aims of this study is to evaluate the two types of tube-fixing with regard to caregiver workload and comfort in performing care. Caregivers will complete identical questionnaires assessing their satisfaction with the two types of tube fixation studied in arms 1 and 2.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient over 18 years old,
* Patient with orotracheal intubation,
* Patient intubated no more than 24 hours previously,
* Oral consent from patient, trusted support person or relative if unable to consent
* Membership of a French health insurance scheme.

Exclusion Criteria

* Pre-existing facial, labial or auricular skin lesions,
* Pre-existing mucositis,
* Patients extubated for more than 24 hours whose condition requires a new intubation tube
* Nasotracheal intubation,
* Planned early tracheotomy,
* Patient with occipital craniectomy,
* Patient in ventral position,
* Pregnant or breast-feeding woman,
* Patient deprived of liberty or under guardianship.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hopital Foch

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marisa LAGOA PINTO

Role: PRINCIPAL_INVESTIGATOR

Hôpital Foch

Locations

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Hôpital Foch

Suresnes, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Marisa LAGOA PINTO

Role: CONTACT

00 33 1 46 25 36 35

Marjolaine NGOLLO, PhD

Role: CONTACT

+33 146 25 37 49

Facility Contacts

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Marisa LAGOA PINTA

Role: primary

00 33 1 46 25 19 46

Other Identifiers

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2023-A01371-44

Identifier Type: OTHER

Identifier Source: secondary_id

2021_0208

Identifier Type: -

Identifier Source: org_study_id

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