Intra hospital transport of ICU patients is still at high risk of respiratory complications.We propose to determine if endotracheal tube clamping prior to disconnect ventilator allows to avoid oxygenation decrease.
Changing respiratory support and multiples endotracheal tube disconnections may induce a loss of PEEP and finally lead to alveolar derecruitment. This study is an evaluation of a care procedure to limit the incidence of alveolar derecruitment in ventilated intubated ICU patients during transport for CT scan. Intra hospital transport of ICU patients are performed by anesthesiologist nurses, the physician entrusts them this activity. This is a randomized controlled study, the procedure is to clamp endotracheal tube before each disconnection from ventilator.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
250
The transport will be released in accordance with SFAR SRLF guideline. Before each disconnection from ventilator endotracheal tube will be clamped.
Departement d'anesthésie et réanimation Gui de Chauliac (DAR C)
Montpellier, France
Measure of the pa02/Fi02
Evaluate the effectiveness of a procedure to avoid alveolar delisting, measured by the absence of a decrease in the PaO2/FiO2 ratio (before transport and 1 hour after return to bed) during an HIT performed by a nurse anaesthetist/caregiver team, of intubated and ventilated resuscitation patients in a controlled assisted volume.
Time frame: 1 hour after the end of the transport
Assessment of the pa02
Evaluate the impact of the procedure on the absence of PaO2 reduction (before transport and 1 hour after return to bed)
Time frame: 1 hour after the end of the HIT
Assessment of the pa02
Evaluate the effectiveness of the procedure on Pa02 immediately after reconnection to the heavy resuscitation ventilator
Time frame: immediately after the end of the HIT
Assessment of the pa02
Evaluate the effectiveness of the procedure on Pa02 immediately after reconnection to the heavy resuscitation ventilator
Time frame: 6 hours after the end of of the HIT
length of stay
Evaluate the impact of the intervention on the length of ICU stay
Time frame: up to 28 days
duration of invasive ventilation
Evaluate the impact of the intervention on the invasive ventilation
Time frame: up to 28 days
occurrence of adverse events during the HIT
occurrence of adverse events related to the clamping
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Time frame: immediately after the end of the HIT