NCT02512744

Brief Summary

Multicenter randomized trial centered on critically-ill tracheostomized patients, comparing two different decannulation protocols:

  1. 1.based on capping trials to decide decannulation,
  2. 2.based on the aspiration frequency to decide decannulation time. High-flow conditioned oxygen therapy will be applied to all patients through the tracheal cannula. In patients included in the suctioning frequency based protocol along the study period and in patients included in the capping trial protocol along periods out of capping trials.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
330

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started May 2016

Typical duration for not_applicable

Geographic Reach
1 country

5 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

First Submitted

Initial submission to the registry

July 27, 2015

Completed
4 days until next milestone

First Posted

Study publicly available on registry

July 31, 2015

Completed
9 months until next milestone

Study Start

First participant enrolled

May 1, 2016

Completed
2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2018

Completed
Last Updated

August 7, 2018

Status Verified

August 1, 2018

Enrollment Period

2 years

First QC Date

July 27, 2015

Last Update Submit

August 6, 2018

Conditions

Keywords

TracheostomyDecannulationAdult airway management

Outcome Measures

Primary Outcomes (1)

  • Decannulation time

    Time since weaning from mechanical ventilation (24 consecutive hours disconnected) to decannulation

    Patients will be followed for the duration of hospital stay, an expected average of 3 months

Secondary Outcomes (6)

  • Decannulation failure

    Patients will be followed for the duration of hospital stay, an expected average of 3 months

  • Intensive Care Unit Lenght of stay

    Patients will be followed for the duration of ICU stay, an expected average of 2 months

  • Hospital lenght of stay

    Patients will be followed for the duration of hospital stay, an expected average of 3 months

  • ICU mortality

    Patients will be followed for the duration of ICU stay, an expected average of 2 months

  • Hospital mortality

    Patients will be followed for the duration of hospital stay, an expected average of 3 months

  • +1 more secondary outcomes

Study Arms (2)

Capping trial protocol

NO INTERVENTION

Decannulation protocol based on tolerance to 24 hours capping trial to decide when to decannulate. Decapping during the capping trial for aspiration of respiratory secretions is considered a failure criteria of the trial. High flow conditioned oxygen therapy through tracheal cannula will be applied during periods out of capping trials.

Suctioning frequency protocol

EXPERIMENTAL

Decannulation protocol based on suctioning frequency to decide when to decannulate (criteria: ≤2 aspirations every 8 h along 24 consecutive hours). Intervention: suctioning frequency of respiratory secretions will be recorded untill fulfill decannulation criteria. Capping trials will not be allowed in this group. High flow conditioned oxygen therapy will be applied through tracheal cannula during all the study period.

Procedure: Decannulation protocol.Device: High flow conditioned oxygen therapy

Interventions

Comparison of two different decannulation protocols: one protocol based on capping trial tolerance to decide when to decannulate vs. protocol based on suctioning frequency of respiratory secretions to decide when to decannulate (criteria: ≤2 aspirations every 8 h along 24 consecutive hours).

Suctioning frequency protocol

High flow conditioned oxygen therapy will be applied during all study period through tracheal cannula in the experimental arm (suctioning frequency based protocol) and during periods out of capping trials in the control arm (capping trials based protocol).

Also known as: OptiflowTM, Fisher&Paykel, Auckland, New Zealand.
Suctioning frequency protocol

Eligibility Criteria

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

You may qualify if:

  • Critically-ill tracheostomized patients weaned from mechanical ventilation (24 consecutive hours disconnected).

You may not qualify if:

  • Patients consedered non-decannulable at time of randomization:
  • unconscious patient (motor component of GCS score \<6 points).
  • Severe swallowing function (based on drink test).
  • Airway patency problem (based of intolerance of occlusion test).
  • Neuromuscular diseases.
  • Patients with a Sabadell score \>2.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (5)

Hospital Del Mar

Barcelona, Spain

Location

Hospital Universitario Vall D´Ebron

Barcelona, Spain

Location

Hospital Universitario de Ciudad Real

Ciudad Real, Spain

Location

Hospital Universitario Ramon Y Cajal

Madrid, Spain

Location

Hospital Virgen de La Salud

Toledo, Spain

Location

Related Publications (1)

  • Hernandez Martinez G, Rodriguez ML, Vaquero MC, Ortiz R, Masclans JR, Roca O, Colinas L, de Pablo R, Espinosa MD, Garcia-de-Acilu M, Climent C, Cuena-Boy R. High-Flow Oxygen with Capping or Suctioning for Tracheostomy Decannulation. N Engl J Med. 2020 Sep 10;383(11):1009-1017. doi: 10.1056/NEJMoa2010834.

Study Officials

  • GONZALO HERNANDEZ, MD

    Hospital Virgen de la Salud

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD

Study Record Dates

First Submitted

July 27, 2015

First Posted

July 31, 2015

Study Start

May 1, 2016

Primary Completion

May 1, 2018

Study Completion

May 1, 2018

Last Updated

August 7, 2018

Record last verified: 2018-08

Locations