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Best practice in stabilisation of oral endotracheal tubes: a systematic review

Gardner, Anne, Hughes, Dot, Cook, Robert A., Henson, Rachael, Osborne, Sonya, & Gardner, Glenn E. (2005) Best practice in stabilisation of oral endotracheal tubes: a systematic review. Australian Critical Care, 18(4), pp. 158-165.

Abstract

Mechanical ventilation of patients in intensive care units is common practice. Artificial airways are utilised to facilitate ventilation and the endotracheal tube (ETT) is most commonly used for this purpose. The ETT must be stabilised to optimise ventilation and avoid displacement or unplanned extubation. Tube movement is a major factor in causing airway trauma. A destabilised tube can cause fatal complications. A systematic review was conducted to identify and analyse the best available evidence on ETT stabilisation to determine which stabilisation method resulted in reduced tube displacement and the least amount of unplanned or accidental extubations. The types of stabilisations included one or a combination of the following methods: twill or cotton tape, adhesive tape, gauze, or a manufactured device. All relevant randomised controlled and quasi-experimental studies of ETT stabilisation practices, identified through electronic and hand searching, were assessed for inclusion in the study. One published randomised controlled trial and six published quasi-experimental studies met the inclusion and exclusion criteria and were retrieved. Data were extracted independently by two reviewers. Results of the systematic review showed that no single method of ETT stabilisation could be identified as superior for minimising tube displacement and unplanned or accidental extubations. Rigorous randomised controlled trials with clearly identified and described ETT stabilisation methods are required to establish best practice. In addition, comparative research to evaluate cost effectiveness and nursing time requirements would also be of significant benefit to critical care nursing practice.

Impact and interest:

10 citations in Scopus
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7 citations in Web of Science®

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ID Code: 3707
Item Type: Journal Article
Additional URLs:
Keywords: Endotracheal tubes, intubation, intratracheal
ISSN: 1036-7314
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Secondary (Acute Care) (111003)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2005 ACCCN
Copyright Statement: The contents of this journal can be freely accessed online via the journal’s web page (see link).
Deposited On: 14 Mar 2006
Last Modified: 29 Feb 2012 23:11

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