Removal of the Intubation Tube Under Positive Pressure With or Without Endotracheal Suctioning During Extubation in Intensive Care: a Prospective Randomised Controlled Trial

What this Trial Is About

Researchers are evaluating endotracheal suctioning during positive pressure extubation in adults who are mechanically ventilated in the intensive care unit (ICU). This study aims to determine if using suction during extubation improves the respiratory oxygenation index (ROX) measured three hours later compared to extubation without suction. The study is prospective, randomized, and controlled, focusing on patients intubated for more than 48 hours and ready for extubation as prescribed by their physician. Participants will be randomly assigned to one of two groups: one group will have the intubation tube removed using endotracheal suctioning while maintaining positive end expiratory pressure (PEEP) and pressure support, with specific settings for vacuum and pressure; the other group will have the tube removed without suctioning but with the same PEEP and pressure support settings. The suctioning device used is a closed-system probe with a standard size. Extubation will be performed by the nursing team in the ICU. After extubation, participants will be monitored for three hours with assessments including respiratory rate, pulse oximetry, and inspired oxygen fraction to evaluate respiratory function. The primary outcome is the ROX index measured three hours after extubation. Secondary outcomes include mechanical ventilation weaning failure and pneumonia occurrence within seven days, as well as airway clearance within 24 hours. Vital status will be recorded 28 days after extubation to complete the study follow-up.

Endotracheal Suctionning During Positive Pressure Extubation in ICU