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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06018220
Other study ID # NEU6021
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date June 27, 2023
Est. completion date June 1, 2024

Study information

Verified date February 2024
Source Rigshospitalet, Denmark
Contact Martin K soerensen, PHD
Phone +45 35457009
Email Martin.Kryspin.Soerensen.01@regionh.dk
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The aim of the present quality study is to examine the relationship between choice of tracheotomy procedure and complications in a neurocritically ill patient population at a single center. Secondary outcomes are the influence of clinician skill level (for PDTs), time from admission to tracheostomy, length of stay and time to decannulation.


Description:

Neurocritically ill patients often require placement of a tracheostomy at some point during admission, as impaired consciousness and insufficient protective airway reflexes often make weaning from mechanical ventilation prolonged. Percutaneous dilatational tracheostomy (PDT) with fiberoptic visualization can be performed bedside by neurointensivists or residents under supervision, unless there are contraindications. However, concerns regarding tracheal stenosis following PDT have been raised. This a rare complication but when it occurs it is a severe long-term complication, and the patients are often in need of repeated interventions. The alternative is surgical tracheostomy (ST) which is more resource intensive but perceived as safer in high risk patients. The indication for tracheostomy (and the choice of procedure) is ultimately based on judgement of clinical team. Systematic reviews have found no difference between PDT and ST regarding severe complications, apart from a higher incidence of wound infections after ST. However, a higher incidence of complications following PDT has been reported when residents are performing the procedure, suggesting an influence of physician skill level. Methods: This is a retrospective observational single-center quality study. All patients > 18 years of age admitted to the Neurointensive Care Unit at Rigshospitalet, Copenhagen between January 2018 and December 2022 with a registered procedure code for either PDT or ST wil be included. Approval from departmental leadership and The Judicial Department at Rigshopitalet has been attained. Data will be extracted from the electronical medical records and any short (< 1 week) or long-term complications will be registered. The follow-up period is 6 months.


Recruitment information / eligibility

Status Recruiting
Enrollment 383
Est. completion date June 1, 2024
Est. primary completion date June 1, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: Patients admitted to Neurointensive Care Unit, Rigshospitalet, Denmark AND having a tracheostomy performed during their stay. - Exclusion Criteria: Children - age < 18.

Study Design


Related Conditions & MeSH terms


Locations

Country Name City State
Denmark Rigshospitalet Copenhagen

Sponsors (1)

Lead Sponsor Collaborator
Rigshospitalet, Denmark

Country where clinical trial is conducted

Denmark, 

Outcome

Type Measure Description Time frame Safety issue
Primary Number of patients with complications following tracheostomy Bleeding; pneumothorax, pneumomediastinum, lost airway, via falsa, procedure-related death, other. Up to 1 week after tracheostomy procedure
Primary Number of patients with complications following tracheostomy - long term. Tracheal stenosis, fistula, wound infection, accidental decannulation, scarring, delayed wound healing, changes in voice or speech, other. From 1 week up to 6 months after the tracheostomy procedure
Secondary Number of complications according to the skilled level of the clinician performing the tracheostomy (only for percutaneous dilatational tracheostomy) Non-skilled residents vs. senior physician Up to 6 months following tracheostomy
Secondary Days Time from admission to tracheostomy, time to decannulation, time to discharge from ICU/hospital Up to 6 months
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