No registrations found.
ID
Source
Brief title
Health condition
In mechanically ventilated patients, endotracheal suctioning will be performed when indicated. During two 6-month periods all ES procedures will be performed with either OSS or CSS. After 6 months, 1 month of wash out/wash in is planned, during which the system is changed.
Sponsors and support
Intervention
Outcome measures
Primary outcome
Occurrence of cross-transmission (primary endpoint), defined as acquired colonization with a genetically identical pathogen with an epidemiological linkage to a potential source patient.
Secondary outcome
Length of stay in ICU, antibiotic use, cardio-respiratory adverse events (hypoxemia, cardiac arrhythmia, damage to respiratory mucosa), mortality, the incidence of VAP and cost-efficacy.
Background summary
Cross-transmission (patient to patient spread) of antibiotic-resistant bacteria frequently occurs in intensive care units (ICUs). Among mechanically ventilated patients the respiratory tract is a preferential site for colonization with such pathogens. For these patients, endotracheal suctioning (ES) is an essential and frequently performed procedure. Yet, disconnection of the ventilation system and endotracheal tube during ES exposes colonized airways and contaminated material to open air with ongoing ventilation, and creates an optimal situation for air-borne spread of pathogens and cross-transmission. Controlling spread of antibiotic-resistant pathogens is of utmost importance in ICUs.
Nowadays, two systems are available for ES: the single use open suction system (OSS) and the 'newer' multiple use closed suction system (CSS). CSS is increasingly used due to presumed patient benefits with regard to adverse physiolgic events and outcome, though we could not confirm these claims upon a systematic review. Importantly, the effects of CSS on reducing cross-transmission have never been evaluated.
Study objective
Cross-transmission of antibiotic-resistant pathogens can be prevented by using closed suction systems (CSS) instead of open suction systems (OSS) in mechanically ventilated ICU patients.
Intervention
Endotracheal suctioning as indicated, according to a protocol, with either CSS or OSS.
I.P. Jongerden
Utrecht 3508 GA
The Netherlands
+ 31(0)30 2503304
i.p.jongerden@umcutrecht.nl
I.P. Jongerden
Utrecht 3508 GA
The Netherlands
+ 31(0)30 2503304
i.p.jongerden@umcutrecht.nl
Inclusion criteria
All adult ICU patients receiving MV will be included and, during 6 months, be subjected to the same ES-procedure.
Exclusion criteria
No exclusion criteria. Preference of ES system is often based on assuptions, there is currently no scientific evidence available to prefer one system over the other.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL759 |
| NTR-old | NTR770 |
| Other | : N/A |
| ISRCTN | ISRCTN75875670 |