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.
ID
Bron
Verkorte titel
Aandoening
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.
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Occurrence of cross-transmission (primary endpoint), defined as acquired colonization with a genetically identical pathogen with an epidemiological linkage to a potential source patient.
Achtergrond van het onderzoek
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.
Doel van het onderzoek
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.
Onderzoeksproduct en/of interventie
Endotracheal suctioning as indicated, according to a protocol, with either CSS or OSS.
Publiek
I.P. Jongerden
Utrecht 3508 GA
The Netherlands
+ 31(0)30 2503304
i.p.jongerden@umcutrecht.nl
Wetenschappelijk
I.P. Jongerden
Utrecht 3508 GA
The Netherlands
+ 31(0)30 2503304
i.p.jongerden@umcutrecht.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
All adult ICU patients receiving MV will be included and, during 6 months, be subjected to the same ES-procedure.
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
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.
Opzet
Deelname
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Andere (mogelijk minder actuele) registraties in dit register
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In overige registers
| Register | ID |
|---|---|
| NTR-new | NL759 |
| NTR-old | NTR770 |
| Ander register | : N/A |
| ISRCTN | ISRCTN75875670 |