When patients in intensive care units need help breathing with machines, doctors often place feeding tubes to deliver nutrition and medicine. This new study will test whether putting the feeding tube through the nose or mouth makes a difference in preventing a serious lung infection called ventilator-associated pneumonia. Researchers at 16 hospitals in France will compare these two methods over two years to see which approach keeps patients safer. This research matters because ventilator-associated pneumonia is a common and dangerous complication in ICU patients, so finding the best tube placement method could help save lives and improve care.

The Quick Take

  • What they studied: Whether placing a feeding tube through the nose versus the mouth affects how often patients on breathing machines develop lung infections in the hospital.
  • Who participated: Critically ill patients in 16 intensive care units across France who need mechanical ventilation and feeding tubes. The study will involve multiple hospitals switching between the two tube placement methods over a two-year period.
  • Key finding: This is a study protocol (a plan for research), not yet completed research. The study aims to determine if nasal tube placement reduces ventilator-associated pneumonia rates compared to oral placement, with results expected after the two-year trial period.
  • What it means for you: If nasal tube placement proves safer, it could become standard practice in ICUs worldwide, potentially reducing serious infections in hospitalized patients. However, results won’t be available until the study is complete, so current practice may vary by hospital.

The Research Details

This is a carefully designed research plan called a cluster randomized crossover trial. Sixteen intensive care units in France will participate. Instead of randomly assigning individual patients, entire hospitals will be assigned to use either nasal or oral feeding tubes for 12 months, then switch to the other method for another 12 months. This approach helps researchers see how the change affects infection rates across whole hospital units. Before the official study begins, there’s a preparation period where staff learn the new procedures to ensure consistency. Between the two main study periods, there’s a monitoring and washout period to make sure results from the first period don’t influence the second period.

This research design is important because it tests real-world hospital practices rather than just laboratory conditions. By having entire units switch methods, researchers can see how the change affects actual patient outcomes in busy ICU settings. The independent verification of lung infections by three separate doctors ensures the results are reliable and not influenced by bias. This approach gives stronger evidence than smaller studies because it involves many patients across multiple hospitals.

This study has strong quality features: it’s approved by an ethics board, involves multiple hospitals for broader results, uses independent verification of infections, and follows strict protocols for patient consent and data protection. The study is registered in a clinical trials database (NCT05915663), which means the plan was made public before results were known, preventing researchers from changing their methods based on outcomes. However, since this is a study protocol rather than completed research, the actual quality of results cannot be assessed until data collection is finished.

What the Results Show

This document describes the study plan rather than actual results. The primary goal is to measure and compare the rate of ventilator-associated pneumonia (a serious lung infection) in patients with nasal versus oral feeding tubes by day 28 of hospitalization. The researchers will have three independent physicians review and confirm each case of pneumonia to ensure accuracy. The study will track hundreds of patients across 16 hospitals over two years to gather enough information to draw reliable conclusions. Once the study is complete, the results will show whether one tube placement method is clearly better at preventing this dangerous infection.

The study will also measure how easy it is to insert each type of feeding tube by counting how many attempts are needed. This matters because easier insertion means less discomfort for patients and less time spent on the procedure. Researchers may also look at other complications, patient comfort levels, and how long tubes stay in place, though these details will be determined as the study progresses.

Current medical practice varies—some hospitals prefer nasal tubes while others use oral tubes. Small previous studies have suggested different results, which is why this large, well-designed trial is needed. This research will provide the strongest evidence yet to help doctors make the best choice for their patients. The findings could change standard practice in intensive care units worldwide if one method proves significantly safer.

Since this is a study protocol, we cannot yet assess actual limitations in the results. However, potential limitations include: the study only involves French hospitals, so results may differ in other countries with different patient populations; patients in emergency situations may not be able to give full consent; and the open-label design means doctors and staff know which method is being used, which could influence their care. The study’s two-year timeline means results won’t be available immediately.

The Bottom Line

This is a study plan, not yet completed research, so specific recommendations cannot be made. Once results are published, they will likely influence ICU protocols worldwide. Currently, doctors should continue following their hospital’s established procedures while awaiting these important findings. High confidence in final recommendations will depend on the study’s results and how clearly one method outperforms the other.

ICU doctors and nurses should follow this research closely, as it will directly affect patient care protocols. Patients and families with loved ones in intensive care should be aware that hospitals may be participating in this study. Hospital administrators and policy makers will use these results to update guidelines. People at risk of needing ICU care (those with serious illnesses or injuries) should know this research aims to improve their safety.

The study began in 2024 and will continue for approximately two years. Results will likely be published in 2026 or 2027. Any changes to hospital practices based on findings would follow publication and peer review, potentially taking several additional months to implement widely.

Want to Apply This Research?

  • For ICU patients or their caregivers using a health tracking app: note the type of feeding tube placement (nasal or oral) used and monitor for any signs of respiratory infection such as fever, increased breathing difficulty, or changes in breathing tube secretions. Track these observations daily to share with the medical team.
  • If you’re a caregiver of an ICU patient, ask your medical team which feeding tube method is being used and why. Request updates on any respiratory status changes. If your hospital is participating in the SONG trial, understand that the tube placement method may change during your loved one’s stay as part of the research protocol.
  • Healthcare providers using an app should track: daily ventilator-associated pneumonia risk factors (fever, tube position changes, oral hygiene measures), feeding tube insertion attempts and ease of placement, and any respiratory complications. This data helps identify patterns and contributes to understanding real-world outcomes that complement the formal research study.

This article describes a research study protocol, not completed research results. The findings discussed are planned outcomes, not established facts. This information is for educational purposes only and should not replace professional medical advice. Decisions about feeding tube placement should be made by qualified healthcare providers based on individual patient needs and current medical evidence. If you or a loved one is in an intensive care unit, discuss all treatment options and their risks with your medical team. This research is ongoing and results are not yet available.