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Oral Mucosal Pressure Injuries and Endotracheal Tube Dislodgement Among Elderly Trauma Patients (mucosal injury)

29 juni 2026 bijgewerkt door: Amal Hashem, Norther Private Collage of Nursing

Oral Mucosal Pressure Injuries and Endotracheal Tube Dislodgement: A Randomized Controlled Trial Comparing Securement Methods in Elderly Trauma Patients

This randomized controlled trial aims to compare the effectiveness of the AnchorFast™ endotracheal tube (ETT) securement device with conventional adhesive tape and gauze fixation in preventing oral mucosal pressure injuries and endotracheal tube dislodgement among mechanically ventilated elderly trauma patients admitted to the intensive care unit. A total of 90 patients aged 65 years and older requiring oral endotracheal intubation will be randomly allocated to one of the three securement methods. The primary outcomes are the incidence and severity of oral mucosal pressure injuries, assessed using the Beck Oral Assessment Scale (BOAS), and ETT displacement measured using the Endotracheal Tube Slippage Scale. Secondary outcomes include unplanned extubation, ease and time of fixation, need for assistance during application, and time to the development of pressure injury. The findings are expected to provide high-quality evidence to guide the selection of optimal ETT securement methods, improve patient safety, reduce device-related complications, and enhance the quality of critical care nursing practice in elderly trauma patients.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Medical device-related pressure injuries (MDRPIs) associated with endotracheal tube (ETT) securement are common complications among mechanically ventilated patients, particularly elderly trauma patients, who are at increased risk due to age-related tissue fragility, impaired tissue perfusion, and prolonged immobilization. In addition to oral mucosal pressure injuries, inadequate ETT fixation may result in tube displacement and unplanned extubation, leading to serious complications such as airway obstruction, hypoxemia, aspiration, reintubation, prolonged mechanical ventilation, and increased healthcare costs. Although several methods are available for securing ETTs, including adhesive tape, gauze, and commercial fixation devices, evidence regarding the optimal securement technique remains limited.

This prospective, three-arm, randomized controlled trial aims to compare the effectiveness of the AnchorFast™ endotracheal tube securement device with conventional adhesive tape and gauze fixation in preventing oral mucosal pressure injuries and reducing ETT dislodgement among mechanically ventilated elderly trauma patients admitted to the intensive care unit (ICU). Ninety eligible patients aged 65 years or older requiring oral endotracheal intubation and expected to receive mechanical ventilation for at least 72 hours will be randomly assigned in a 1:1:1 ratio to one of the three securement methods. Standardized airway management, oral care, and routine repositioning protocols will be implemented for all participants throughout the study period.

The primary outcomes are the incidence and severity of oral mucosal pressure injuries, assessed using the Beck Oral Assessment Scale (BOAS), and endotracheal tube displacement measured using the Endotracheal Tube Slippage Scale. Secondary outcomes include unplanned extubation, fixation time, ease of device application, need for assistance during fixation, number of re-fixations, time to first pressure injury, duration of mechanical ventilation, and ICU length of stay. The study is expected to generate high-quality evidence regarding the safest and most effective ETT securement strategy for elderly trauma patients and support the development of evidence-based protocols aimed at reducing device-related complications, improving

Studietype

Ingrijpend

Inschrijving (Werkelijk)

90

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Saoedi-Arabië
      • Arar, Saoedi-Arabië
        • Norther Private Colleague of Nursing

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

  • Inclusion Criteria

    1. Age ≥65 years old and more.
    2. Newly admission to trauma ICU following traumatic injury
    3. Patient attached with EET and mechanical ventilation
    4. Expected duration of mechanical ventilation for 72 hours and more.
    5. Hemodynamically stable (MAP ≥65 mmHg with or without vasopressors)
    6. Informed consent obtained from patient or legally authorized representative
    7. Enrollment within 6 hours of intubation

Exclusion Criteria:

  • Extubation:

    1. Pre-existing tracheostomy and planned tracheostomy within 72 hours
    2. Patients with facial trauma or facial burns or active facial skin.
    3. Known allergy to adhesive materials or device components
    4. Active facial skin infection or significant dermatologic condition
    5. Enrollment in another interventional study
    6. Do-not-resuscitate status or comfort care designation
    7. Expected survival less than 72 hours based on clinical judgment
    8. Oral surgery or oral infection or inflammation.
    9. A previous neck injury, projecting upper teeth, or the absence of teeth.
    10. Radiotherapy-induced oral mucositis.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: experimental arm 1
endotracheal tube securement device. The AnchorFast™ endotracheal tube securement device is a commercially available, single-use device designed to stabilize oral endotracheal tubes while allowing easy tube repositioning for oral care. The device includes a tube clamp, lip stabilizer, and adhesive skin barrier pads to minimize tube movement, reduce pressure on the oral tissues, and decrease the risk of oral mucosal pressure injuries and unplanned extubation.
Procedure: AnchorFast : Endotracheal Tube Securement Device
The AnchorFast: endotracheal tube securement device is a single-use commercial device designed to stabilize oral endotracheal tubes while allowing easy repositioning for oral care. It incorporates a tube clamp, lip stabilizer, and adhesive skin barrier pads to minimize tube movement, reduce pressure on oral tissues, and prevent unplanned extubation and medical device-related pressure injuries.
Actieve vergelijker: Active Comparator Arm 1
Conventional adhesive tape securement. The endotracheal tube will be secured using conventional medical adhesive tape applied according to institutional airway management protocols to maintain tube position during mechanical ventilation.
Procedure: AnchorFast : Endotracheal Tube Securement Device
The AnchorFast: endotracheal tube securement device is a single-use commercial device designed to stabilize oral endotracheal tubes while allowing easy repositioning for oral care. It incorporates a tube clamp, lip stabilizer, and adhesive skin barrier pads to minimize tube movement, reduce pressure on oral tissues, and prevent unplanned extubation and medical device-related pressure injuries.
Actieve vergelijker: Active Comparator Arm 2
Conventional gauze tape securement.The endotracheal tube will be secured using non-elastic gauze tape wrapped around the tube and fixed according to the institutional protocol to maintain airway stability during mechanical ventilation.
Procedure: AnchorFast : Endotracheal Tube Securement Device
The AnchorFast: endotracheal tube securement device is a single-use commercial device designed to stabilize oral endotracheal tubes while allowing easy repositioning for oral care. It incorporates a tube clamp, lip stabilizer, and adhesive skin barrier pads to minimize tube movement, reduce pressure on oral tissues, and prevent unplanned extubation and medical device-related pressure injuries.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Incidence and Severity of Oral Mucosal Pressure Injuries
Tijdsspanne: From intubation until extubation or up to 14 days after endotracheal intubation.
Oral mucosal pressure injuries will be assessed using the Beck Oral Assessment Scale (BOAS). The scale evaluates the condition of the lips, gingiva, oral mucosa, tongue, teeth/dentures, and saliva. Higher scores indicate poorer oral health and greater severity of oral mucosal injury
From intubation until extubation or up to 14 days after endotracheal intubation.
Endotracheal Tube (ETT) Dislodgement
Tijdsspanne: From intubation until extubation or up to 14 days.
Endotracheal tube displacement will be evaluated using the Endotracheal Tube Slippage Scale, which measures the extent of tube movement from the original fixation point and classifies the risk of accidental extubation.
From intubation until extubation or up to 14 days.

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Unplanned Extubation
Tijdsspanne: During ICU stay (up to 14 days).
Number of accidental or self-extubation events occurring during mechanical ventilation.
During ICU stay (up to 14 days).

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Norther Private Collage of Nursing

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Nuttige links

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 december 2025

Primaire voltooiing (Werkelijk)

30 april 2026

Studie voltooiing (Werkelijk)

29 mei 2026

Studieregistratiedata

Eerst ingediend

29 juni 2026

Eerst ingediend dat voldeed aan de QC-criteria

29 juni 2026

Eerst geplaatst (Werkelijk)

6 juli 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

6 juli 2026

Laatste update ingediend die voldeed aan QC-criteria

29 juni 2026

Laatst geverifieerd

1 december 2025

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Andere studie-ID-nummers

  • Oral Mucosal Pressure Injuries

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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