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Tracheostomy PatientsON TRACHNCT07769021

Tracheostomy Practice in Adult Intensive Care Units

An observational study of Tracheostomy Patients and Tracheostomy Decannulation, run by Royal College of Surgeons, Ireland at 13 sites in 8 countries.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

ON TRACH is an international, multicentre, observational study with the aim of characterising the timing and practice of tracheostomy insertion, management, weaning and longer-term outcomes of these patients, in intensive care units internationally. Read more about this study

Who is it for?
Ages 18 years and older
How many people
2,500 participants
Where
13 sitesin 8 countries
Study dates
2 Nov 2026to Mar 2029
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: All patients aged 18 years and older admitted in the intensive care unit after commencement of the enrolment period, and that are in receipt of invasive ventilator support, will be screened daily until ICU discharge or death. Those that undergo tracheostomy insertion during critical care admission will be included in the study.

Who may be able to join

  • Greater than 18 years of age
  • Tracheostomy insertion during critical care admission

Who cannot join

  • Tracheostomy prior to critical care admission
  • Elective tracheostomy insertion for head and neck pathology
  • Tracheostomy insertion for emergency surgical management of airway obstruction
  • Mini tracheostomy insertion only

Trial locations and contacts

13 sites in 8 countries. Contact the study team or a site near you to ask about taking part.

Aisling Mc Mahon, MB BCh BAO FCAI FJFICMI contact

+35318032204

aislingmcmahon@mater.ie

Michelle Smyth, BSc contact

michellesmyth@rcsi.ie

13 sites in 8 countries

Ireland3 sites
  • Beaumont Hospital

    Dublin

    Michelle Smyth, +353868823764, michellesmyth@rcsi.ie

    Ger Curley

  • Mater Misericordiae University Hospital Dublin

    Dublin

    Aisling Mc Mahon, +353861091104, aislingmcmahon@mater.ie

    Stephen Murphy

  • Galway University Hospital

    Galway

    John Laffey, MD DSc, +353 91 544315, jlaffey@universityofgalway.ie

    John Laffey, MD Dsc

Other trials in Ireland

Italy3 sites
  • Ospedale Policlinico San Martino Genoa

    Genova

    Denise Battaglini, PhD, +39 010 5551, battaglini.denise@gmail.com

    Denise Battaglini, PhD

  • University of Naples Frederico II

    Naples

    Maria Vargas, PhD, +39 081 253 1111, vargas.maria82@gmail.com

    Maria Vargas, PhD

  • University Hospital San Luigi Gonzaga Turin

    Torino

    Vincenzo Russotto, MD, +39 011 90261

    Vincenzo Russotto, MD

Other trials in Italy

United States2 sites
  • University of Michigan Health Ann Arbor

    Ann Arbor, Michigan, 48109

    Michael Brenner, MD, 734-936-4000, mbren@med.umich.edu

    Michael Brenner, MD

  • Beth Israel Medical Centre

    Boston, Massachusetts, 02215

    Elisabeth Riviello, MD, 617-667-7000, eriviell@bidmc.havard.edu

    Elisabeth Riviello, MD

Other trials in United States

Brazil1 site
  • Nereu Ramos Hospital

    Florianópolis

    Israel Maia, MD, +48 3216-9300, israels.maia@gmail.com

    Israel Maia, MD

Other trials in Brazil

Canada1 site
  • Toronto General Hospital

    Toronto

    Matteo Parotto, PhD, 416-340-4800, matteo.parotto@uhn.ca

    Matteo Parotto, PhD

Other trials in Canada

India1 site
  • Tata Memorial Hospital

    Mumbai

    Shiela Myatra, MD, +91 22 2417 7000, shiela150@hotmail.com

    Shiela Myatra, MD

Other trials in India

Switzerland1 site
  • University Hospital of Lausanne

    Lausanne

    Lise Piquilloud Imboden, PhD, +41 21 314 11 11, lise.piquilloud@chuv.ch

    Lise Piquilloud Imboden, PhD

Other trials in Switzerland

United Kingdom1 site
  • Manchester University Hospital

    Manchester

    Brendan Mc Grath, PhD, +44 161 276 1234, brendan.mcgrath@manchester.ac.uk

    Brendan Mc Grath, PhD

Other trials in United Kingdom

About this study

Official title: Observational iNternational Study of TRACHeostomy Practice in Adult Intensive Care Units - ON TRACH

ON TRACH is an international, multicentre, observational study with the aim of characterising the timing and practice of tracheostomy insertion, management, weaning and longer-term outcomes of these patients, in intensive care units internationally. Participating intensive care units (ICU) will recruit all consecutive patients undergoing tracheostomy insertion over a 12 week period, aiming for broad global representation. This will allow identification of variation in care of patients with a tracheostomy in the intensive care and it's origin, to drive improvement and enhance safety and outcomes for patients with a tracheostomy in the future.

Read the detailed description

Care of the patient with a tracheostomy is a core element of critical care practice. Around 20% of patients admitted to an intensive care unit (ICU) undergo tracheostomy insertion during their stay, typically in the context of prolonged mechanical ventilation and complex rehabilitation needs. Despite its frequent use and ongoing quality improvement initiatives, considerable variation in practice continues to exist and many questions with regards to tracheostomy timing, insertion, management and longer-term outcomes remain.

Variation exists not only because of patient characteristics, but also from an organisational perspective with diversity in hospital settings, system demands and governance structures. These inconsistencies lead to deficiencies in care and avoidable harm, increased morbidity and mortality.

This is an international multicentre prospective observational study to comprehensively characterise current tracheostomy practice. The study aims to describe the indications, timing, techniques, and management of tracheostomy insertion and care; to evaluate patient-centred outcomes and procedure-related adverse events; and to explore the organisational structures and models of care supporting tracheostomised patients in the ICU and beyond. This will allow us to identify variation in care, it's origin, drive improvement and enhance safety and outcomes for patients with a tracheostomy in the future.

Keywords
tracheostomy, decannulation, intensive care, prolonged mechanical ventilation, tracheostomy weaning, tracheostomy outcomes

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07769021
Study groupRoleWhat they receive
Critical care patients with a tracheostomyParticipants will include patients 18 years and older, admitted to the intensive care, who undergo tracheostomy insertion as part of their critical care admission.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Successful tracheostomy decannulation

    The proportion of patients successfully decannulated from tracheostomy, censored at hospital discharge or 90 days, whichever comes first.

    Measured: 90 days

Secondary outcomes (7)
  1. Time to decannulation

    Time to successful decannulation censored at hospital discharge or 90 days, whichever comes first.

    Measured: 90 days

  2. Mortality

    Measured: 90 days

  3. Hospital utilization metrics

    Duration of mechanical ventilation, ICU and hospital length of stay

    Measured: 90 days

  4. Return to vocalisation

    Measured by time in days to placement of a speaking valve

    Measured: 90 days

  5. Return to oral intake

    Measured using the Functional Oral Intake Scale (FOIS) which ranges from level 1 to 7, where level 1 is no oral intake and level 7 is full oral intake with no restrictions.

    Measured: 90 days

  6. Return to mobilisation

    Measured using the Intensive Care Mobility Scale which ranges from 1 to 10 with 10 indicating a greater degree of mobility.

    Measured: 90 days

  7. Health related quality of life

    Quality of life measured using the EuroQol five-dimensional questionnaire (EQ-5D-5L) with a lower score indicating a better quality of life.

    Measured: 3, 6 and 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Aug 2026
  2. Study start2 Nov 2026 (estimated)
  3. Primary completionNov 2028 (estimated)
  4. Study completionMar 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
2,500 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07769021
Sponsor's protocol ID
26/54
Other IDs
ESICM 2026 Lachmann Grant
Acronym
ON TRACH
Status last verified
Jul 2026
First submitted
27 Jul 2026
Last updated
17 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Abe T, Madotto F, Pham T, Nagata I, Uchida M, Tamiya N, Kurahashi K, Bellani G, Laffey JG; LUNG-SAFE Investigators and the ESICM Trials Group. Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries. Crit Care. 2018 Aug 17;22(1):195. doi: 10.1186/s13054-018-2126-6.

    PubMed 30115127
  • Premraj L, Camarda C, White N, Godoy DA, Cuthbertson BH, Rocco PRM, Pelosi P, Robba C, Suarez JI, Cho SM, Battaglini D. Tracheostomy timing and outcome in critically ill patients with stroke: a meta-analysis and meta-regression. Crit Care. 2023 Apr 1;27(1):132. doi: 10.1186/s13054-023-04417-6.

    PubMed 37005666
  • Selekwa M, Maina I, Yeh T, Nkya A, Ncogoza I, Nuss RC, Mushi BP, Haddadi S, Van Loon K, Mbaga E, Massawe W, Roberson DW, Dharsee N, Musimu B, Xu MJ. Tracheostomy care quality improvement in low- and middle-income countries: A scoping review. PLOS Glob Public Health. 2023 Nov 9;3(11):e0002294. doi: 10.1371/journal.pgph.0002294. eCollection 2023.

    PubMed 37943736
  • Vargas M, Sutherasan Y, Antonelli M, Brunetti I, Corcione A, Laffey JG, Putensen C, Servillo G, Pelosi P. Tracheostomy procedures in the intensive care unit: an international survey. Crit Care. 2015 Aug 13;19(1):291. doi: 10.1186/s13054-015-1013-7.

    PubMed 26271742
  • Merola R, Vargas M, Sanfilippo F, Vergano M, Mistraletti G, Vetrugno L, De Pascale G, Bignami EG, Servillo G, Battaglini D. Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey. Medicina (Kaunas). 2025 Jan 7;61(1):87. doi: 10.3390/medicina61010087.

    PubMed 39859070
  • Polok K, Fronczek J, van Heerden PV, Flaatten H, Guidet B, De Lange DW, Fjolner J, Leaver S, Beil M, Sviri S, Bruno RR, Wernly B, Artigas A, Pinto BB, Schefold JC, Studzinska D, Joannidis M, Oeyen S, Marsh B, Andersen FH, Moreno R, Cecconi M, Jung C, Szczeklik W; COVIP study group. Association between tracheostomy timing and outcomes for older critically ill COVID-19 patients: prospective observational study in European intensive care units. Br J Anaesth. 2022 Mar;128(3):482-490. doi: 10.1016/j.bja.2021.11.027. Epub 2021 Nov 29.

    PubMed 34955167
  • Zaga CJ, Milliren CE, McGrath BA, Yang CJ, Schiff BA, Warrillow SJ, Henningfeld JK, Gregson PA, Bedwell JR, Beaudet KM, Brenner MJ, Pandian V. Predictors of Decannulation Success in Tracheostomy: A 10-Year Analysis of the Global Tracheostomy Collaborative Database. Otolaryngol Head Neck Surg. 2025 Nov;173(5):1138-1148. doi: 10.1002/ohn.70013. Epub 2025 Sep 2.

    PubMed 40891658
  • Carton E, Fitzgerald E, Elebert R, Malone C, O'Brien S, Dunne A, Ni Muircheartaigh R, Phelan D. Changes in Multidisciplinary Tracheostomy Team Practice Over Time. Ir Med J. 2021 Sep 20;114(8):433.

    PubMed 35863078
  • Mikhaeil M, Bernard M, Currie J, Bolduc C, Radke J, Kranjc S, Meyer J. Improving weaning and liberation from mechanical ventilation for tracheostomy patients: a quality improvement initiative. BMJ Qual Saf. 2025 Jun 19;34(7):480-488. doi: 10.1136/bmjqs-2024-018324.

    PubMed 40318863
  • McGrath BA, Wallace S, Lynch J, Bonvento B, Coe B, Owen A, Firn M, Brenner MJ, Edwards E, Finch TL, Cameron T, Narula A, Roberson DW. Improving tracheostomy care in the United Kingdom: results of a guided quality improvement programme in 20 diverse hospitals. Br J Anaesth. 2020 Jul;125(1):e119-e129. doi: 10.1016/j.bja.2020.04.064. Epub 2020 May 31.

    PubMed 32493580
  • Brenner MJ, Davies EA, McGrath BA. Reducing variation in tracheostomy care can improve outcomes. Br J Anaesth. 2022 Apr;128(4):e282-e284. doi: 10.1016/j.bja.2022.01.008. Epub 2022 Feb 8. No abstract available.

    PubMed 35144800
  • Brenner MJ, Pandian V, Milliren CE, Graham DA, Zaga C, Morris LL, Bedwell JR, Das P, Zhu H, Lee Y Allen J, Peltz A, Chin K, Schiff BA, Randall DM, Swords C, French D, Ward E, Sweeney JM, Warrillow SJ, Arora A, Narula A, McGrath BA, Cameron TS, Roberson DW. Global Tracheostomy Collaborative: data-driven improvements in patient safety through multidisciplinary teamwork, standardisation, education, and patient partnership. Br J Anaesth. 2020 Jul;125(1):e104-e118. doi: 10.1016/j.bja.2020.04.054. Epub 2020 May 23.

    PubMed 32456776
  • Gentile MN, Irvine AD, King AM, Hembrom AS, Guruswamy KS, Palivela NE, Langton-Frost N, McElroy CR, Pandian V. Enhancing Communication in Critically Ill Patients with a Tracheostomy: A Systematic Review of Evidence-Based Interventions and Outcomes. Tracheostomy. 2024;1(1):26-41. doi: 10.62905/001c.115440. Epub 2024 Mar 31.

    PubMed 39253605
  • Damuth E, Mitchell JA, Bartock JL, Roberts BW, Trzeciak S. Long-term survival of critically ill patients treated with prolonged mechanical ventilation: a systematic review and meta-analysis. Lancet Respir Med. 2015 Jul;3(7):544-53. doi: 10.1016/S2213-2600(15)00150-2. Epub 2015 May 20.

    PubMed 26003390
  • Dempsey GA, Morton B, Hammell C, Williams LT, Tudur Smith C, Jones T. Long-Term Outcome Following Tracheostomy in Critical Care: A Systematic Review. Crit Care Med. 2016 Mar;44(3):617-28. doi: 10.1097/CCM.0000000000001382.

    PubMed 26584197

Questions about this trial

What is this clinical trial studying?

An observational study of Tracheostomy Patients and Tracheostomy Decannulation, run by Royal College of Surgeons, Ireland at 13 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 17 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in Ireland, Italy, United States, Brazil, Canada and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Aisling Mc Mahon, MB BCh BAO FCAI FJFICMI (+35318032204, aislingmcmahon@mater.ie), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Successful tracheostomy decannulation (time frame: 90 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07769021, which also lists 32 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Aug 2026.

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