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NCT06113939Not yet recruitingPhase 4

Prevention of Infection of the Respiratory Tract Through Application of Non-Invasive Methods of Secretion Suctioning

Prevention of Infection of the Respiratory Tract by Applying Methods That Are Non-Invasive for Extraction of Secretions. An Open Label, Randomized, Assessor-blinded Trial.

Source: ClinicalTrials.gov · Last updated 6 Aug 2026

Brief summary (registry, in English)

Adults who are unconscious or severely ill and need a breathing tube connected to a ventilator are at high risk of developing a lung infection (pneumonia) within the first few days in the intensive care unit. This early pneumonia affects up to 30 to 50 % of certain high-risk patients, prolongs the time on the ventilator and in hospital, and increases the use of antibiotics. Two strategies are commonly used today to try to prevent this infection: a short, three-day course of an intravenous antibiotic, and removal of secretions from the airway with a sterile suction catheter. Both have limitations - antibiotics can favour the growth of resistant bacteria, and catheter suctioning is uncomfortable and may injure the airway. PIRÁMIDES is a small (60-patient) pilot study that compares the current practice with two non-invasive, mechanical alternatives for keeping the airway clear: a continuous low-pressure suction system built into a special breathing tube, and a device that produces a gentle, programmed "artificial cough" through the ventilator. Adult patients who are intubated for severe trauma, severe brain injury, stroke, resuscitated cardiac arrest or other causes of decreased consciousness are randomly assigned, in equal numbers, to one of the three approaches and followed for 14 days, with a final visit at day 90. The main goal is to find out which of the three strategies best prevents early pneumonia, and which provides the best overall result for patients when survival, severity of infection, need for additional antibiotics and side effects are considered together. To make these comparisons as fair as possible in an open-label study, an independent committee of doctors not involved in patient care reviews each suspected pneumonia case without knowing which strategy the patient received. The results will help design a larger trial to confirm which approach is safest and most effective for preventing early pneumonia in critically ill patients on a ventilator.

Status (registry)
Not yet recruiting
Phase (registry)
Phase 4
Study type
Interventional
Enrollment
60 (estimated)
First submitted
10 Oct 2023
Start date
15 Sept 2026
Primary completion date
30 Dec 2028
Lead sponsor
Hospital San Carlos, Madrid
Diseases
Stroke
NCT number
NCT06113939
EU CT number
2025-521454-42-00

What you commit to

  • Study type: Interventional · Phase 4
  • Planned participants: 60
  • From 15 Sept 2026 to the primary completion date, 30 Dec 2028
  • 1 site in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Other illness

  • Already established indication for systemic antibiotic therapy, either for suspected aspiration pneumonia with radiological pulmonary infiltrate or for suspected non-respiratory source infection.
  • Active haemoptysis or pulmonary haemorrhage.
  • Known allergy or intolerance to beta-lactam antibiotics.

Other

  • Intubation with an anticipated duration \< 48 hours.
  • Foreseeable ominous prognosis within \< 7 days.
  • Unstable chest.
  • Undrained pneumothorax (inclusion may be considered once drained).

Who the study is looking for

  • Endotracheal intubation with an anticipated duration \> 48 hours.
  • High risk of early respiratory infection associated with a diagnosis of:
    • Severe trauma.
    • Severe traumatic brain injury.
    • Ischaemic or haemorrhagic stroke.
    • Other causes of impaired consciousness: post-resuscitated cardiac arrest status, intoxications, acute infections or diseases of the central nervous system, seizures.
  • Informed consent signed by the patient or, when impossible due to clinical status, by their legal representative, with re-consent by the patients themselves upon regaining capacity (section 15).

Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (1)

Sites in registry order. Save your city in your profile to sort them by distance.

SiteCityCountrySite status
Hospital Clínico San Carlos
Coordinator of this site? Confirm its status
MadridSpainNot yet recruiting

This page is information, not medical advice. Discuss any trial with your doctor.