None listed
Conditions
Brief summary
Following cardiac surgery, patients may experience respiratory problems and reduced lung function. This may cause low oxygen levels and often a longer hospital stay. Reduced lung function may also be resistant to simple techniques traditionally used to improve lung function such as patient positioning and physiotherapy. Ensuring adequate oxygen levels post-operatively is vital but there is little published evidence to guide doctors in the selection and use of different oxygen therapy systems. A high flow nasal high oxygen system (Optiflow by Fisher and Paykel Healthcare Ltd) has been shown to deliver some positive airway pressure and this may help lung function. We now wish to study this to see if this is true. Patients in the study will either receive the nasal high flow oxygen or oxygen delivered by a standard face/nasal mask for 24hours after coming off the breathing machine post-operatively. If this proves to be true, patients may well be discharged earlier from the ICU and from hospital, thereby shortening hospital stay and improving hospital throughput.
Interventions
Patients undergoing cardiac surgery will be invited pre-operatively to participate in this study. At the time of extubation and discontinuation of mechanical ventilation in the ICU post-operatively, patients in the intervention arm will be randomised to receive oxygen therapy for a period of 24 hours via nasal high flow (Optiflow system, Fisher and Paykel Healthcare, NZ Ltd) at 45 L/min. Fraction of inspired oxygen will be titrated to acheive oxygen saturations of >93%. Study treatment will be d
Patients undergoing cardiac surgery will be invited pre-operatively to participate in this study. At the time of extubation and discontinuation of mechanical ventilation in the ICU post-operatively, patients in the intervention arm will be randomised to receive oxygen therapy for a period of 24 hours via nasal high flow (Optiflow system, Fisher and Paykel Healthcare, NZ Ltd) at 45 L/min. Fraction of inspired oxygen will be titrated to acheive oxygen saturations of >93%. Study treatment will be discontinued at 1000hours post-operative day 2 and need for ongoing oxygen therapy assessed.
Sponsors
Auckland City Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients will be screened and are eligible for inclusion in the study if all of the following criteria are met: : over 18 years of age : informed consent obtained : scheduled for cardiac surgery involving full median sternotomy. : cardiac surgery = CABG; valvular; CABG + valve : patient not normally on NIV at home : patient is extubated prior to 1000 hours day after surgery
Exclusion criteria
Patients will be excluded if any of the following exist: : contraindication for NHF use e.g. severe nasal septal defect : need for timely NIV e.g. CPAP to treat obstructive sleep apnoea : previous recruitment into this study : patient is likely to be intubated and mechanically ventilated for >24 hours following operation : post-operatively patient is still ventilated at 1000 post-op day 1
Outcome results
None listed