Comparison Between a Standard Tube and the Ultra-thin Tritube for Intubation of the Trachea and for Maintaining Access to the Trachea After Anaesthesia, in Patients With an Expected Difficult Direct Laryngoscopy (Tritube)
Sammenligning Mellem Standard Tube og Den Ultra-tynde Tritube® Til Intubation, og Til Opretholdelse af Adgang Til Trachea Efter anæstesi, Hos Patienter Med Forventet Vanskelig Direkte Laryngoskopi
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
In patients scheduled for surgery and anaesthesia in the Head-/neck/ear/nose/throat -region the investigators compare the ease of tracheal intubation between a new ultra-thin endotracheal tube, "Tritube", and a standard endotracheal tube in patients with predictors of difficult laryngoscopy. The intubation is performed with an angulated video laryngoscope.
Furthermore the investigators compare the acceptance of leaving the Tritube in trachea after end of anaesthesia, with the use of a tube exchange catheter. The latter continues into the post-operative recovery-ward.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Michael S Kristensen, MD
- Phone Number: 004535458033
- Email: michael.seltz.kristensen@regionh.dk
Study Locations
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-
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Copenhagen, Denmark, 2100
- Rigshospitalet, section for anaesthesia for ENT and Maxillofacial surgery, section 3071
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients for anaesthesia for surgery in the Head-/neck/ear/nose/throat
- planned for oral intubation with video-laryngoscopy
- with risk factors for difficult direct laryngoscopy
Exclusion Criteria:
- Patient with increased secretions in the airway (Pneumonia, bronchitis, productive cough)
- Patients planned for awake intubation
- Patients where mask-ventilation is judged to could become impossible
- Patients where access to the cricothyroid membrane is judged to be difficult or impossible
- Patients in ASA (american Society of Anaesthesiologists) physical classification status >3
- Patients who are scheduled for rapid sequence induction (RSI) due to risk of aspiration
- Patients with stridor
- Patients with hypoxemia (Saturation < 90 % in room air)
- Operation duration planned to > 2.5 hours
- Patients with the need for a nerve-stimulation-tube during surgery
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Tritube
|
The ultra thin tribute is used used for the ventilation of the patients in this arm
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Active Comparator: Standard endotracheal tube
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A standard endotracheal tube is used used for the ventilation of the patients in this arm
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of Excellent intubation conditions
Time Frame: 2 hours
|
Rate of Excellent intubation conditions judged on the scale excellent/good/fair/poor
|
2 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The rate of interruption by the tube of the view to the vocal cords at any time, to such a degree that it disturbs the intubation
Time Frame: 2 hours
|
2 hours
|
|
|
The Intubation Difficulty Score (IDS)
Time Frame: 2 hours
|
The intubation difficulty scale , range 0 to 7, 0 indicates easy intubation, 1 - 5 indicates slight difficulty, 5< indicates moderate to major difficulty
|
2 hours
|
|
Time to intubated
Time Frame: 2 hours
|
Time from the tube is advanced past the vocal cords until the cuff is inflated in the trachea
|
2 hours
|
|
Time to the patient becomes ventilated via the tube
Time Frame: 2 hours
|
Time from the tube is advanced past the vocal cords until the cuff is inflated in the trachea and CO2 waveform is observed
|
2 hours
|
|
Number of intubation attempts
Time Frame: 2 hours
|
one attempt is every-time the tube is advanced past the incisors
|
2 hours
|
|
The rate of succesful intubation with 60 seconds
Time Frame: 1 minute
|
1 minute
|
|
|
Number of remodellings of the stilette
Time Frame: 2 hours
|
2 hours
|
|
|
rate of use for "reverse loading" of the tube on the stylet
Time Frame: 2 hours
|
2 hours
|
|
|
the "percent of glottic opening" , (POGO), Before the tube is inserted
Time Frame: 2 hours
|
2 hours
|
|
|
the"percent of glottic opening" , POGO, with the tube in place
Time Frame: 2 hors
|
2 hors
|
|
|
Intubation conditions Strom scale
Time Frame: 2 hours
|
Direction of the tube-stylet combination excellent/good/poor, easy/fair/difficult.
Advancement of the tube-stylet combination excellent/good/poor easy/fair/difficult
|
2 hours
|
|
The surgeons score of the space and working conditions in the mouth/pharynx and larynx after intubation
Time Frame: 2 hours
|
2 hours
|
|
|
The difference between ET CO2 and arterial blood-gas CO2 after 15 minutes of surgery
Time Frame: 20 minutes
|
20 minutes
|
|
|
the duration of the Tritube being in the trachea after return of spontaneous ventilation and deflation of the cuff /(Tritube group)
Time Frame: 4 hours
|
4 hours
|
|
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The duration of the tube-exchange catheter being in the trachea after its placement / (Tube-exchange-catheter group)
Time Frame: 4 hours
|
4 hours
|
|
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The ration of patients who still has the Tritube or the tube-exchange-catheter in place when arriving in the post-operative recovery unit
Time Frame: 4 hours
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4 hours
|
|
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The ration of patients who still has the Tritube or the tube-exchange-catheter in place one hour after arrival in the Post anaesthesia care unit the post-operative recovery unit
Time Frame: 4 hours
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4 hours
|
|
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The patient's satisfaction with having the Tritube or the tube-exchange-catheter in place when being awake in the Post anaesthesia care unit
Time Frame: 4 hours
|
Visual analog scale from 1-10, 1= no nuisance, 10= unberable
|
4 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Michael S Kristensen, MD, Rigshospitalet, University Hospital of Copenhagen Denmark
Publications and helpful links
General Publications
- Fuchs-Buder T, Claudius C, Skovgaard LT, Eriksson LI, Mirakhur RK, Viby-Mogensen J; 8th International Neuromuscular Meeting. Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision. Acta Anaesthesiol Scand. 2007 Aug;51(7):789-808. doi: 10.1111/j.1399-6576.2007.01352.x.
- Kristensen MS, de Wolf MWP, Rasmussen LS. Ventilation via the 2.4 mm internal diameter Tritube(R) with cuff - new possibilities in airway management. Acta Anaesthesiol Scand. 2017 Jul;61(6):580-589. doi: 10.1111/aas.12894. Epub 2017 Apr 23.
- Strom C, Barnung S, Kristensen MS, Bottger M, Tvede MF, Rasmussen LS. Tracheal intubation in patients with anticipated difficult airway using Boedeker intubation forceps and McGrath videolaryngoscope. Acta Anaesthesiol Scand. 2015 Oct;59(9):1154-60. doi: 10.1111/aas.12543. Epub 2015 May 16.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Neoplasms
- Neoplasms by Site
- Respiratory Tract Neoplasms
- Otorhinolaryngologic Neoplasms
- Head and Neck Neoplasms
- Pharyngeal Diseases
- Stomatognathic Diseases
- Otorhinolaryngologic Diseases
- Mouth Diseases
- Laryngeal Diseases
- Mouth Neoplasms
- Laryngeal Neoplasms
- Pharyngeal Neoplasms
Other Study ID Numbers
Other Study ID Numbers
- H-18023689 Tritube
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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