Impact of the Choice of Gastric Tube Placement Sites on the Incidence of Ventilator Associated Pneumonia

Study Overview
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Brief Summary
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In intensive care, many gastric tubes are inserted on a regular basis. There are different practices in terms of the location of the gastric tube. In some cases, the tube is inserted through the nose and in others, it is inserted through the mouth. In the literature and in practice, these gastric tubes create discomfort and complications that have an impact not only on the patient, but also on the treatments and the length of the patient's stay in hospital. Nosocomial Ventilator Associated Pneumonia is the most serious common complication for patients intubated with a gastric tube. It is possible that placement site may have an impact on the risk of developing Ventilator Associated Pneumonia, particularly by increasing the risk of bacterial pululation opposite the sinuses when the tube is placed via the nasal route. Investigator hypothesises that placing the gastric tube orally will reduce the rate of ventilator-associated pneumonia compared with the nasal route in mechanically ventilated intensive care patients.

Official Title
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Impact of the Choice of Gastric Tube Placement Sites on the Incidence of Ventilator Associated Pneumonia and Other Complications in the Intensive Care Unit

Conditions
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Intubated Patient Requiring a Gastric Tube

Intervention / Treatment
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* Other: nasogastric tube and orogastric tube
* Other: orogastric tube and nasogastric tube


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient in intensive care, intubated, ventilated Adult Requiring a gastric tube With an expected duration of mechanical ventilation of more than 48 hours Affiliated to social security Patient or relative consent or, failing that, emergency inclusion of the patient Exclusion Criteria: Pregnant, breast-feeding or parturient women Patients under legal protection: curatorship and guardianship Contraindication to placing a gastric tube through the nose or mouth Patients who already have a gastric tube when they enter the service Patient intubated for more than 24 hours Patient intubated via the nasotracheal route

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Randomised cluster and cross-over study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arm A<br>nasogatric tube in period 1 and orogastric tube in period 2 | Other: nasogastric tube and orogastric tube<br>* nasogastric tube in period 1 and orogastric tube in period 2<br>|
| Experimental: Arm B<br>orogastric tube in period 1 and nasogatric tube in period 2 | Other: orogastric tube and nasogastric tube<br>* orogastric tube in period 1 and nasogastric tube in period 2<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compare impact of insertion site of gastric tube on the incidence of ventilator associated pneumoniae | The impact is measured by the number of ventilator associated peumoniae | Day 28 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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orogastric tube, nasogastric tube, Ventilator Associated Pneumonia