The primary aim of this study is to evaluate the CleanSweep™ Closed Suction System on time to first successful spontaneous breathing trial in mechanically ventilated patients in the medical intensive care unit. Secondary aims of this study are to evaluate the use endotracheal tube sweeping compared to closed suctioning effect on length of mechanical ventilation, length of ICU stay, length of total hospital stay, and occurrence of ventilator-associated events.
This is designed as a prospective, randomized control trial, in a large, urban, academic medical center. This study will include mechanically ventilated patients (n = 272) in the medical intensive care unit (MICU) at Rush University Medical Center. It will exclude patients with a tracheostomy on admission, those requiring extracorporeal membrane oxygenation (ECMO), or transferred from an outside facility receiving more than 24 hours of mechanical ventilation. Two groups will be randomly assigned via computer randomization. The experimental group will be placed on the CleanSweep™ Closed Suction System immediately after intubation or upon arrival to the MICU. Endotracheal tubes (ETTs) will be cleaned with the balloon sweeping technology every time a respiratory therapist suctions the patient. The control group will be placed on the standard in-line suction device. Airway suctioning will be performed in both groups as per department policy (Catheter advanced until resistance is met and withdrawn slowly for a duration no longer than 15 seconds while applying negative pressure). Both groups will also receive a ventilator bundle that consists of head of bed elevation, ETT cuff pressure management, deep vein thrombosis prevention, daily sedation interruption and SBT, and oral care every 4 hours with chlorhexidine at 12pm (noon) and 12am midnight.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
272
Device with balloon sweeping technology
Rush University Medical Center
Chicago, Illinois, United States
Length of Time on a Mechanical Ventilator
Length of time on mechanical ventilation was recorded in hours.
Time frame: Hospital admission to discharge (up to about 20 days)
Time to First Successful Spontaneous Breathing Trial (SBT)
Time to first successful SBT in mechanically ventilated patients in the medical intensive care unit.
Time frame: Hospital admission to discharge (up to about 20 days)
Length of Time in the Intensive Care Unit
Length of time spent in the intensive care units in days
Time frame: Hospital admission to discharge (up to about 20 days)
Length of Total Hospital Stay
Length of total time spent in the hospital in days
Time frame: Hospital admission to discharge (up to about 20 days)
Number of Participants With Ventilator-associated Events
Number of Participants with ventilator-associated events, like pneumonia
Time frame: Hospital admission to discharge (up to about 20 days)
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