McCann 1988.
| Methods | A 2 phase study design. Three methods of endotracheal tube stabilization were compared. Phase 1 randomly selected subjects for one of 3 taping methods. Method 1 involved "HSC Tapes" (HSCT = Hospital for Sick Children Tapes), the name given for the existing taping method of adhesive tape with string supports. Method 2 involved "HSCT plus suture" which meant a sutured strip of adhesive bandage was applied to the neonates upper lip in a moustache fashion, then the suture was inserted vertically through both sides of the endotracheal tube and secured with HSCT. Method 3 involved "waterproof tapes plus suture" which meant the adhesive bandage was applied as described in method 2, and 2 pieces of waterproof tape cut in a trouser leg pattern were applied to secure the endotracheal tube. Phase 2 selected subjects for 2 taping methods. The taping methods were Method 2 and Method 3 as described in Phase 1. Patients were recruited over a 10 month period, each phase lasting 5 months each. | |
| Participants | "The convenience sample of one hundred and twenty‐five patients represented a characteristic population in a sixty bed tertiary referral NICU" | |
| Interventions | All 3 methods used naso‐endotracheal tubes. Waterproof tapes with suture method consisted of tincture of benzoin on the infants upper lip and cheeks, and applying pre‐sutured adhesive dressing in moustache fashion. Silk suture was inserted vertically through both sides of the endotracheal tube (ETT) and some length was left. A knot was tied proximal to nares and distal to nares. Waterproof tape in trouser leg pattern was used with the bottom leg of waterproof tape on top of moustache adhesive dressing. The upper leg was wrapped around the ETT in clockwise fashion. A second piece of waterproof tape was used and the upper leg was wrapped around the ETT in counter‐clockwise fashion | |
| Outcomes | Rates of accidental extubation of the 3 methods Difference in rates of accidental extubation over the different study phases Nursing perception of factors which contributed to accidental extubations |
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| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Not stated how the random sequence was generated |
| Allocation concealment (selection bias) | Unclear risk | Not stated whether the allocation list was sealed |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Treatment could not be blinded due to the nature of the study |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not stated whether the assessment of the outcomes were blinded |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Data were collected on all intubated neonates |
| Selective reporting (reporting bias) | Unclear risk | Not stated whether all results were reported |
| Other bias | Unclear risk | Not stated whether the groups were similar at the start of the trial. Not stated whether the groups were treated equally apart from the intervention |