Endotracheal Suctionning During Positive Pressure Extubation in ICU

Condition(s) studied

Investigational drug(s) / intervention(s)

Suctionning extubation: We will remove the intubation tube with endotracheal suctioning during the extubation procedure and maintain positive end expiratory pressure (PEEP) and pressure support. The PEEP level will be 10 cmH2O and the pressure support 7 cmH2O for 2 minutes prior to extubation. The vacuum level will be the maximum level (standard procedure in the unit), i.e. 450 mmHg. The closed-system suction probe is inserted up to the last mark corresponding to 40cm. The size of our closed system is identical for all patients, i.e. 14 french.

No suctionning Extubation: In the control group, removal of the intubation tube during the extubation procedure is performed with PEEP maintained, without endotracheal suctioning. The PEEP level will be set at 10 cmH2O and the pressure at 7 cmH2O in the 2 minutes prior to extubation.

Study summary

The aim of this clinical trial is to evaluate endotracheal suctioning during positive pressure extubation in mechanically ventilated adult patients (over 18 years old) in the intensive care unit (ICU). The main question it aims to answer is whether the intervention improves the respiratory oxygenation index (ROX) three hours after extubation compared to no endotracheal suction during positive pressure extubation.

Participants will only need to be extubated by the nursing team in the ICU. Follow-up will consist of evaluating respiratory rate, pulse oximetry and inspired oxygen fraction for three hours following extubation.

Eligibility

Primary outcome measure(s)

• Respiratoy/oxygenation index (ROX index) — 3 hours after extubation
  Rox index will be assessed 3 hours after extubation by an investigator with no information about randomization (blind assessment)

Trial sites (1)

More Centre Hospitalier Régional d'Orléans trials in France

Other trials for the same condition