ArticleNursing in critical care2026
Endotracheal Tube Repositioning Frequency for Preventing Oral Mucosal Pressure Injuries in Intensive Care Units: A Randomised Controlled Trial Study Protocol.
Article in Nursing in critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07390162 (The Effect of Changes in the Frequency of Endotracheal Tube Repositioning in Intensive Care Units on the Prevention of Oral Mucosal Pressure Injuries), which is not on this map. Not yet cited in PubMed.
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The Effect of Changes in the Frequency of Endotracheal Tube Repositioning in Intensive Care Units on the Prevention of Oral Mucosal Pressure Injuries
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3 authors.
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Abstract
backgroundEndotracheal tubes (ETTs) exert sustained pressure and friction on the oral mucosa, placing mechanically ventilated intensive care unit (ICU) patients at increased risk of mucosal membrane pressure injuries (MMPIs).
aimTo compare the effect of 4-h and 8-h ETT repositioning intervals on the prevention of oral MMPIs in adult ICU patients receiving invasive mechanical ventilation (MV).
methodsThis study is designed as an analyst-blinded, parallel-group randomised controlled trial. Adult ICU patients receiving invasive MV via an oral ETT and with Acute Physiology and Chronic Health Evaluation System (APACHE II) scores ≤ 24 will be randomised (1:1) to either 4-h or 8-h ETT repositioning intervals, with stratification by APACHE II score (≤ 20 and 21-24). The primary outcome is the development of oral MMPIs during a 14 day follow-up period or until extubation, tracheostomy, transfer or death, assessed using the Reaper Oral Mucosa Pressure Injury Scale-TR. Secondary outcomes include the timing, severity, and anatomical location of MMPIs.
resultsThe primary hypothesis is that a 4-h ETT repositioning interval will significantly reduce the incidence of oral MMPIs compared to an 8-h interval. It is anticipated that more frequent repositioning will better preserve mucosal integrity and improve patient comfort. These results are expected to provide evidence-based guidance for standardizing nursing-led ETT care protocols in ICU. RELEVANCE FOR CLINICAL PRACTICE: By examining ETT repositioning intervals in relation to disease severity, this study may support more standardised and patient-centred preventive strategies and contribute to safer, more efficient nursing care in intensive care settings.
trial registrationThe Clinical Trial Registration number (Unique Protocol ID) is NCT07390162.
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