NCT00199576

Brief Summary

Tracheal intubation is a frequent procedure in intensive care units (ICU). Post-extubation laryngeal edema is a frequent complication with potential morbidity and mortality, and may lead to urgent tracheal re-intubation. Corticosteroids have been proposed to reduce the incidence of post-extubation laryngeal edema. A few clinical studies have been conducted in adult ICU patients and have led to discrepant results. These discrepancies may be related to the time lag separating the administration of the corticosteroids and the planned extubation. Accordingly, we tested the hypothesis that pretreatment with corticosteroids initiated 12 hours before a planned extubation may efficiently prevent the occurrence of postextubation laryngeal edema in critically-ill adults who have been mechanically ventilated for more than 36 hours in the ICU.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
670

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started Dec 2000

Shorter than P25 for phase_3

Geographic Reach
1 country

15 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

December 1, 2000

Completed
1.1 years until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2002

Completed
3.7 years until next milestone

First Submitted

Initial submission to the registry

September 12, 2005

Completed
8 days until next milestone

First Posted

Study publicly available on registry

September 20, 2005

Completed
Last Updated

September 20, 2005

Status Verified

September 1, 2005

First QC Date

September 12, 2005

Last Update Submit

September 12, 2005

Conditions

Keywords

CorticosteroidsLaryngotracheal injuryIntubation-extubation

Outcome Measures

Primary Outcomes (1)

  • Onset of a laryngeal edema within 24 hours after a planned tracheal extubation

Secondary Outcomes (3)

  • - Severity of laryngeal edema (minor or major)

  • - Time to onset of edema (in minutes) after tracheal extubation

  • - Need for a tracheal re-intubation

Interventions

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult ≥ 18 years
  • Intubated for ≥ 36 hours
  • Scheduled extubation
  • Informed written consent

You may not qualify if:

  • pregnancy
  • history of postextubation laryngeal dyspnea
  • laryngeal disease
  • tracheotomy
  • patient receiving corticotherapy prior to admission
  • traumatic intubation
  • participation to this study or to another trial

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (15)

Réanimation médicale et chirurgicale - Hôpital d'Angoulême

Angoulême, France

Location

Service de Réanimation - CH de Brive

Brivé, France

Location

Service de Réanimation - CH de Chartres

Chartres, France

Location

Service de Réanimation - CH de Chateauroux

Châteauroux, France

Location

Réanimation polyvalente - Hôpital de Cholet

Cholet, France

Location

Service de Réanimation - CH de Dreux

Dreux, France

Location

Service de Réanimation - CH de Le Mans

Le Mans, France

Location

Service de Réanimation Polyvalente - Hôpital Dupuytren

Limoges, 87042, France

Location

Réanimation polyvalente - Hôpital d'Orléans

Orléans, France

Location

Service Réanimation - CH de Poitiers

Poitiers, France

Location

Service de Réanimation - CH de Saint Nazaire

Saint-Nazaire, France

Location

Service de Réanimation - CH de Saintes

Saintes, France

Location

Service de Réanimation - CH Saint Malo

St-Malo, France

Location

Réanimation Médicale - Hôpital Bretonneau

Tours, France

Location

Service de Réanimation - CH de Vannes

Vannes, France

Location

Related Publications (4)

  • Kastanos N, Estopa Miro R, Marin Perez A, Xaubet Mir A, Agusti-Vidal A. Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study. Crit Care Med. 1983 May;11(5):362-7. doi: 10.1097/00003246-198305000-00009.

    PMID: 6839788BACKGROUND
  • Darmon JY, Rauss A, Dreyfuss D, Bleichner G, Elkharrat D, Schlemmer B, Tenaillon A, Brun-Buisson C, Huet Y. Evaluation of risk factors for laryngeal edema after tracheal extubation in adults and its prevention by dexamethasone. A placebo-controlled, double-blind, multicenter study. Anesthesiology. 1992 Aug;77(2):245-51. doi: 10.1097/00000542-199208000-00004.

    PMID: 1642342BACKGROUND
  • Ho LI, Harn HJ, Lien TC, Hu PY, Wang JH. Postextubation laryngeal edema in adults. Risk factor evaluation and prevention by hydrocortisone. Intensive Care Med. 1996 Sep;22(9):933-6. doi: 10.1007/BF02044118.

    PMID: 8905428BACKGROUND
  • Francois B, Bellissant E, Gissot V, Desachy A, Normand S, Boulain T, Brenet O, Preux PM, Vignon P; Association des Reanimateurs du Centre-Ouest (ARCO). 12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial. Lancet. 2007 Mar 31;369(9567):1083-9. doi: 10.1016/S0140-6736(07)60526-1.

MeSH Terms

Interventions

Methylprednisolone

Intervention Hierarchy (Ancestors)

PrednisolonePregnadienetriolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic Compounds

Study Officials

  • Eric Bellissant, MD, PhD

    CHU Rennes

    STUDY CHAIR
  • Bruno Francois, MD

    CH Limoges

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
DOUBLE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER

Study Record Dates

First Submitted

September 12, 2005

First Posted

September 20, 2005

Study Start

December 1, 2000

Study Completion

January 1, 2002

Last Updated

September 20, 2005

Record last verified: 2005-09

Locations