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Bronchoscopic Versus Airway Exchange Catheter-Guided Endotracheal Tube Exchange (Bronchex)

10 juillet 2026 mis à jour par: Léo Franchetti

Bronchoscopic Endotracheal Tube Exchange as an Alternative to Airway Exchange Catheter-Guided Tube Exchange: A Prospective Study

This prospective experimental study compares two methods for replacing an endotracheal tube in Thiel-embalmed body donors. The conventional method uses an airway exchange catheter based on the Seldinger technique, whereas the investigational method uses a flexible bronchoscope to provide direct visual guidance throughout the exchange.

The primary outcome is the duration of interrupted ventilation, measured from cessation of ventilation until ventilation is resumed through a correctly positioned replacement tube. Secondary outcomes include unsuccessful tube exchange requiring complete reintubation, duration of individual procedural steps, procedures lasting more than 60 seconds, use of additional rescue equipment, and unforeseen technical difficulties.

Both techniques will be performed in two Thiel-embalmed donated human bodies using an alternating sequence. Four experienced physicians will perform 40 tube exchanges per technique, resulting in a total of 80 procedures.

Aperçu de l'étude

Statut

Recrutement

Les conditions

Intervention / Traitement

Description détaillée

Endotracheal tube exchange may be required because of cuff failure, inappropriate tube size, tube damage, luminal obstruction, or the need for a planned intervention. During conventional tube exchange over an airway exchange catheter, continuous visualization of the subglottic airway and trachea is not possible. Consequently, advancement of the replacement tube may fail or may result in airway injury.

The bronchoscopic tube-exchange technique is intended to provide continuous visual control throughout the procedure and immediate confirmation of the replacement tube position.

The study will be conducted using two human bodies donated for medical education and research and preserved using the Thiel embalming method. Before each experimental series, the donated body will be intubated with a 7.5-mm endotracheal tube, and tracheobronchial secretions will be suctioned.

Two experienced physicians in intensive care medicine and anesthesiology will perform the conventional airway exchange catheter-guided technique, and two experienced pulmonologists will perform the bronchoscopic technique. To minimize order, learning, and tissue-wear effects, the techniques will be alternated. The starting technique will differ between the two body donors.

Each physician will perform 10 tube exchanges per body donor using the assigned technique, resulting in 20 procedures per physician, 40 procedures per technique, and 80 procedures overall.

Procedure timing will be based on predefined start and end points. The primary interval begins when ventilation is interrupted and ends when ventilation is resumed through the correctly positioned replacement tube. A trained observer will record procedural times, individual procedural steps, technical difficulties, use of additional equipment, and unsuccessful exchanges using a standardized source document.

Where feasible, video or photographic documentation may be used to verify procedure timing and technical events. The face will remain covered to prevent identification of the body donor.

Continuous outcomes will be analyzed using the paired Wilcoxon signed-rank test. Paired dichotomous outcomes will be analyzed using the McNemar test. Descriptive statistics will include medians, interquartile ranges, and ranges.

Type d'étude

Interventionnel

Inscription (Estimé)

2

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Sauvegarde des contacts de l'étude

Lieux d'étude

  • Suisse
      • Basel, Suisse
        • Recrutement
        • Unversity Hospital of Basel
        • Contact:
          • Léo Franchetti, MD

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

  • Human body donor preserved using the Thiel embalming method.
  • Intact trachea without relevant postmortem or preparation-related lesions.
  • Documented consent for scientific use of the body and confirmation of anatomical suitability by the Institute of Anatomy.
  • Sufficient mobility of the neck, jaw, and laryngeal region to permit realistic tube-exchange maneuvers.

Exclusion Criteria:

  • Tumor or stenosis involving the larynx, trachea, or central airways.
  • Previous surgery or radiotherapy involving the larynx or oral cavity.
  • Previous pneumonectomy.
  • Previous tracheotomy or laryngectomy.
  • Inability to achieve safe or standardized positioning of the cadaver.
  • Incomplete consent documentation or unclear provenance.
  • Preservation using a fixation method other than the Thiel method.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Autre
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation séquentielle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur actif: Airway Exchange Catheter
The body donors will undergo a tube exchange with the conventional airway exchange catheter-guided technique
Procédure: Airway Exchange Catheter-Guided Endotracheal Tube Exchange
The existing tube fixation is released. A Cook airway exchange catheter is advanced through the in-situ endotracheal tube into the tracheobronchial tree. Ventilation is interrupted, the cuff is deflated, and the old tube is removed over the catheter. A new endotracheal tube is advanced over the catheter, the catheter is removed, the cuff is inflated, ventilation is resumed, and tube position is verified by lung auscultation.
Autres noms:
  • Cook Catheter Tube Exchange
Expérimental: Bronchoscopic tube exchange
The body donors will undergo a tube exchange with the bronchoscopic tube-exchange technique
Procédure: Bronchoscope-Guided Endotracheal Tube Exchange
The replacement tube is preloaded onto a therapeutic flexible bronchoscope. The bronchoscope is advanced alongside the in-situ tube through the larynx into the trachea, and proximal tracheal secretions are suctioned. Ventilation is interrupted and the old tube is removed. The replacement tube is advanced over the bronchoscope into the trachea under direct visual control. The bronchoscope is removed, the cuff is inflated, and ventilation is resumed.
Autres noms:
  • Bronchoscopic tube exchange

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Ventilation interruption time during endotracheal tube exchange
Délai: During each tube-exchange procedure, from ventilation interruption to resumption (expected duration less than 5 minutes).
Time in seconds from interruption of ventilation until ventilation is resumed through the correctly positioned replacement tube
During each tube-exchange procedure, from ventilation interruption to resumption (expected duration less than 5 minutes).

Mesures de résultats secondaires

Mesure des résultats
Délai
Unsuccessful tube exchange requiring complete reintubation - number and proportion of exchanges in which the assigned technique is abandoned and full reintubation is required.
Délai: Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Duration of individual procedural steps - time in seconds for predefined components, including preparation and tube advancement.
Délai: Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Tube exchanges lasting more than 60 seconds - number and proportion of procedures with ventilation interruption exceeding 60 seconds.
Délai: Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Use of additional rescue equipment - number and proportion of exchanges requiring an additional device, such as a laryngoscope.
Délai: Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Unforeseen technical difficulties - type and frequency of technical problems not predefined in the protocol.
Délai: Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).
Assessed during each tube-exchange procedure (approximately 5 minutes per procedure).

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Léo Franchetti

Collaborateurs

University Hospital, Basel, Switzerland

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

10 juillet 2026

Achèvement primaire (Estimé)

10 juillet 2026

Achèvement de l'étude (Estimé)

10 juillet 2026

Dates d'inscription aux études

Première soumission

10 juillet 2026

Première soumission répondant aux critères de contrôle qualité

10 juillet 2026

Première publication (Réel)

15 juillet 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

15 juillet 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

10 juillet 2026

Dernière vérification

1 juillet 2026

Plus d'information

Termes liés à cette étude

Mots clés

Autres numéros d'identification d'étude

  • EKNZ 2026-01277

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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