REDECAP
Trial question
What is the role of high-flow oxygen and suctioning for tracheostomy decannulation in critically ill adults?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
32.0% female
68.0% male
N = 330
330 patients (105 female, 225 male).
Inclusion criteria: critically ill adult patients in the ICU who had a tracheostomy tube after being weaned from mechanical ventilation.
Key exclusion criteria: contraindication for decannulation at randomization, an age < 18 years, expected death before hospital discharge.
Interventions
N=169 intervention (assessment of suctioning frequency plus receipt of continuous high-flow oxygen therapy).
N=161 control (24-hour capping trial plus receipt of intermittent high-flow oxygen therapy).
Primary outcome
Time to decannulation
6 days
13 days
13.0 days
9.8 days
6.5 days
3.3 days
0.0 days
Intervention
Control
Significant
decrease ▼
Significantly shorter time to decannulation (6 days vs. 13 days; AD -7 days, 95% CI -5 to -9).
Secondary outcomes
Significant decrease in decannulation failure (2.4% vs. 5.6%; ARD -3.2, 95% CI -8.1 to -1.2).
No significant difference in weaning failure (6.5% vs. 16.8%; ARD -10.3, 95% CI -17.4 to 3.4).
No significant difference in duration of hospital stay (48 days vs. 62 days; AD -14 days, 95% CI -33 to 9).
Conclusion
In critically ill adult patients in the ICU who had a tracheostomy tube after being weaned from mechanical ventilation, intervention was superior to control with respect to time to decannulation.
Reference
Gonzalo Hernández Martínez, Maria-Luisa Rodriguez, Maria-Concepción Vaquero et al. High-Flow Oxygen with Capping or Suctioning for Tracheostomy Decannulation. N Engl J Med. 2020 Sep 10;383(11):1009-1017.
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