Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12612000432819
Ethics application status
Approved
Date submitted
16/04/2012
Date registered
17/04/2012
Date last updated
17/04/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of saline instillation during physiotherapy (SIP) in the intensive care unit - a randomized crossover trial
Query!
Scientific title
Saline instillation during physiotherapy in intubated patients and the effect on sputum volume
Query!
Secondary ID [1]
280331
0
Nil
Query!
Universal Trial Number (UTN)
U1111-1130-0169
Query!
Trial acronym
Saline Instillation during Physiotherapy (SIP)
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Critically ill intubated intensive care patients
286293
0
Query!
Condition category
Condition code
Infection
286530
286530
0
0
Query!
Other infectious diseases
Query!
Injuries and Accidents
286531
286531
0
0
Query!
Other injuries and accidents
Query!
Injuries and Accidents
286532
286532
0
0
Query!
Burns
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Instillation of 2mls Sodium Chloride isotonic solution 0.9% into the artificial airway via the lavage port prior to physiotherapy treatment. Those allocated to group A will receive saline instillation prior to suction during physiotherapy on day one, day two no saline will be used. The reverse will happen for those patients allocated to group B. There will be a washout period of 24 hours between interventions.
Query!
Intervention code [1]
284689
0
Treatment: Other
Query!
Comparator / control treatment
No instillation of fluid prior to physiotherapy treatment
Query!
Control group
Active
Query!
Outcomes
Primary outcome [1]
286963
0
Secretions will be collected in a sputum trap (Tyco Healthcare Kendall Argyle) attached to the closed suction system. The freeze dried weight will be measured
Query!
Assessment method [1]
286963
0
Query!
Timepoint [1]
286963
0
Immediately at the end of intervention
Query!
Secondary outcome [1]
297059
0
Airway resistance (Raw) cm H2O/L/second
This measure will be derived from the mechanical ventilator.
Query!
Assessment method [1]
297059
0
Query!
Timepoint [1]
297059
0
Before and immediately after the intervention
Query!
Secondary outcome [2]
297129
0
PaO2/FiO2 or Oxygenation ratio
This indicates the ratio of the oxygenation of the patient relative to the amount of inspired oxygen they are receiving. It is calculated by dividing the PaO2 (as measured by an arterial blood gas) by the fraction of inspired oxygen (from the ventilator).Two mls of arterial blood will be taken from the arterial line by a heparized syringe and analysed using a benchtop Arterial Blood Gas Analyser (ABL 700 Series gas Machines, RADIOMETER, Copenhagen, Denmark).
Query!
Assessment method [2]
297129
0
Query!
Timepoint [2]
297129
0
An arterial blood gas will be taken immediately pre, post and 60 minutes post intervention.
Query!
Secondary outcome [3]
297130
0
Haemodynamics: blood pressure (systolic, mean, diastolic) BP, heart rate (HR), rhythm, respiratory rate (RR).
This will ensure that the addition of saline fluid does not adversely affect haemodynamics.
Query!
Assessment method [3]
297130
0
Query!
Timepoint [3]
297130
0
This is measured continuously via the ECG and the arterial line. This will be recorded every ten seconds during the physiotherapy treatment with the actual time of saline instillation marked and the values printed from the monitor (Intellivue, Phillips) after the procedure.
Query!
Secondary outcome [4]
297131
0
SpO2 - oxygen saturation
The amount of oxygen dissolved in the haemoglobin. It is measured non-invasively by a probe on the finger.
Query!
Assessment method [4]
297131
0
Query!
Timepoint [4]
297131
0
This is measured continuously and will be recorded every 10 seconds and a hard copy printed at the completion of the measurement period.
Query!
Eligibility
Key inclusion criteria
1] Adults >18 years, mechanically ventilated
2] Expected to be ventilated for >48 hours
3] Arterial line in situ (for blood pressure measurement and to calculate P/F ratio)
4] Next of kin or patient able to provide informed consent
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
100
Years
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
1] Compassionate care only
2] Condition that contraindicates respiratory physiotherapy eg high intracranial pressure, unstable haemodynamics, undrained pneumothorax, frank haemoptysis, acute pulmonary oedema
3] Ventilation modes such as high frequency oscillation
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The personnel determining eligibility and gaining consent will be unaware of group allocation. The allocation sequence will be concealed from these personnel as they will be stored on a password protected computer.
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The sequence will be generated using a randomization table created by computer software.
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
Query!
Query!
Query!
Query!
Intervention assignment
Crossover
Query!
Other design features
Query!
Phase
Phase 2 / Phase 3
Query!
Type of endpoint/s
Safety/efficacy
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Not yet recruiting
Query!
Date of first participant enrolment
Anticipated
1/06/2012
Query!
Actual
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
Query!
Date of last data collection
Anticipated
Query!
Actual
Query!
Sample size
Target
35
Query!
Accrual to date
Query!
Final
Query!
Recruitment in Australia
Recruitment state(s)
Query!
Funding & Sponsors
Funding source category [1]
285109
0
Self funded/Unfunded
Query!
Name [1]
285109
0
Query!
Address [1]
285109
0
Query!
Country [1]
285109
0
Australia
Query!
Primary sponsor type
University
Query!
Name
University of Queensland
Query!
Address
Burns, Trauma & Critical Care Research Centre
Dept Intensive Care Medicine.
Level 3, NHB,
Royal Brisbane & Womens Hospital,
Butterfield St
Herston Queensland 4029
Query!
Country
Australia
Query!
Secondary sponsor category [1]
283964
0
Hospital
Query!
Name [1]
283964
0
Royal Brisbane & Womens Hospital
Query!
Address [1]
283964
0
Burns, Trauma & Critical Care Research centre
Dept Intensive Care Medicine.
Level 3, NHB,
Royal Brisbane & Womens Hospital,
Butterfield St,
Herston Queensland, 4029
Query!
Country [1]
283964
0
Australia
Query!
Ethics approval
Ethics application status
Approved
Query!
Ethics committee name [1]
287118
0
Royal Brisbane & Women's Hospital Human Research Ethics Committee
Query!
Ethics committee address [1]
287118
0
Royal Brisbane & Women's Hospital, Block 7, Floor 7, Butterfield St, Herston 4029 QLD
Query!
Ethics committee country [1]
287118
0
Australia
Query!
Date submitted for ethics approval [1]
287118
0
Query!
Approval date [1]
287118
0
13/04/2012
Query!
Ethics approval number [1]
287118
0
HREC/12/QRBW/60
Query!
Summary
Brief summary
Insertion of an artificial airway for respiratory failure, either endotracheal, nasotracheal or tracheostomy, inhibits normal mucociliary clearance, thus increasing the risk of secretion retention and pneumonia. Suctioning of the artifical airway is one of the most common procedures in the intensive care unit and high dependency wards: the aim is to remove respiratory tract secretions, thus maintaining airway patency, and prevent complications of secretion retention. Normal saline instillation is defined as delivery of 2 to 10 cc of normal saline solution (0.9%) into an artificial airway prior to suctioning. This technique is utilised by many health practitioners and is believed to increase sputum yield by diluting and loosening secretions, stimulating a cough and lubricating the suction catheter. However, there are conflicting views about the safety and efficacy of this procedure. To date studies have investigated saline instillation as a stand alone technique and not as part of a respiratory physiotherapy regimen. The aim of this trial is to examine the effects of normal saline instillation on sputum clearance, haemodynamic parameters, oxygenation and respiratory mechanics during physiotherapy in patients with an artificial airway. Design Prospective, single blinded, randomised, cross-over design where patients act as their own controls. Patients will be randomised using a computer generated sequence. Those allocated to group A will have saline instillation prior to suction during physiotherapy on day one, day two no saline will be used. The reverse will happen for those patients allocated to group B. Investigator collecting outcome measures will be blinded to group allocation. Participants Adults >18 years, expected to be mechanically ventilated for >48 hours. Outcome measures The primary outcome measure is sputum weight. Sputum will be collected during physiotherapy.Secondary outcome measures include airway resistance, oxygenation, blood pressure and heart rate which will be calculated at various times pre and post procedure. Significance This study would add to the body of knowledge regarding the efficacy and safety of saline instillation during physiotherapy in the intensive care unit.
Query!
Trial website
Query!
Trial related presentations / publications
Query!
Public notes
Query!
Contacts
Principal investigator
Name
34071
0
Query!
Address
34071
0
Query!
Country
34071
0
Query!
Phone
34071
0
Query!
Fax
34071
0
Query!
Email
34071
0
Query!
Contact person for public queries
Name
17318
0
Kellie Stockton
Query!
Address
17318
0
Burns, Trauma & Critical Care Research Centre
Dept Intensive Care Medicine,
Level 3, NHB
Royal Brisbane & Womens Hospital,
Butterfield St
Herston, Queensland, 4029
Query!
Country
17318
0
Australia
Query!
Phone
17318
0
+61 7 36367893
Query!
Fax
17318
0
+61 7 36363542
Query!
Email
17318
0
[email protected]
Query!
Contact person for scientific queries
Name
8246
0
Dr Jennifer Paratz
Query!
Address
8246
0
Burns, Trauma & Critical Care Research Centre
Dept Intensive Care Medicine,
Level 3, NHB
Royal Brisbane & Womens Hospital,
Butterfield St,
Herston, Queensland, 4029
Query!
Country
8246
0
Australia
Query!
Phone
8246
0
+61 7 36361980
Query!
Fax
8246
0
+61 7 36363542
Query!
Email
8246
0
[email protected]
Query!
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF