None listed
Conditions
Brief summary
This study will determine the safety and effectiveness of nasal high flow therapy to improve the respiratory function of adult ward patients in hospitals in New Zealand. The primary outcome will be an improvement in respiratory function as indicated by reductions in respiratory and heart rates and improvement in blood oxygen as measured via the pulse oximeter (SpO2) within an hour of commencing nasal high flow oxygen therapy. Secondary outcomes include improved difficulty in breathing and phlegm clearance and no evidence of delays in escalating to higher levels of care, such as an intensive care unit, within an hour of commencing nasal high flow oxygen therapy and over the next 72 hours. . The study will recruit a minimum of 300 adult ward patient (150 medical and 150 surgical) receiving nasal high flow oxygen therapy in New Zealand hospitals where the use of nasal high flow oxygen therapy in the ward setting is an established practice. Data will be collected using a data collection sheets consisting of 2 parts: 1) hospital demographics and 2) patient data. Data related to blood results, length of stay and discharge outcome will be collected from the patients’ electronic records by site coordinators. Patient data will be de-identified prior to entering the data into a Survey Monkey data base and exporting to a statistical software package for analysis.
Interventions
Nasal high flow (NHF) oxygen therapy will be delivered via the Optiflow™ system (Fisher and Paykel Healthcare, NZ Ltd) using the AIRVO™ 2 (Fisher and Paykel Healthcare, NZ Ltd) to adult ward patients. Data on patients' pulmonary function will be collected immediately prior to commencing nasal high flow oxygen and until the therapy is discontinued or up to 72 hours after the intervention was commenced. Patients will receive NHF oxygen therapy as determined by the Patient at Risk team or ICU outr
Nasal high flow (NHF) oxygen therapy will be delivered via the Optiflow™ system (Fisher and Paykel Healthcare, NZ Ltd) using the AIRVO™ 2 (Fisher and Paykel Healthcare, NZ Ltd) to adult ward patients. Data on patients' pulmonary function will be collected immediately prior to commencing nasal high flow oxygen and until the therapy is discontinued or up to 72 hours after the intervention was commenced. Patients will receive NHF oxygen therapy as determined by the Patient at Risk team or ICU outreach nurse. Oxygen and Airvo 2 flow rate (FiO2) and Airvo 2 temperature will be altered by the Patient at Risk team or ICU outreach nurse in response to respiratory rate, oxygen saturations, work of breathing and comfort.
Sponsors
Alison Pirret
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. All patients in a hospital where NHF oxygen therapy is already being used in adult ward patients. 2. All ward patients greater than 18 years of age with clinical signs of ongoing hypoxaemia associated with an acute or acute on chronic condition and receiving oxygen delivered via low flow nasal prongs or mask OR 3. All ward patients greater than 18 years of age who are at risk of respiratory deterioration as per clinician’s assessment AND 4. Have NHF oxygen therapy delivered via the Optiflow™ system (Fisher and Paykel Healthcare, NZ Ltd) using the AIRVO™ 2 (Fisher and Paykel Healthcare, NZ Ltd) AND 5. In a hospital that utilises an early warning score to identify patient deterioration AND 6. In a hospital that has an intensive care outreach nurse/team and/or Patient at Risk team involved in their care. AND 7. Has ability to provide informed consent in their well state.
Exclusion criteria
Patients receiving end of life care, facial trauma/surgery patients, patients with conditions that contraindicate the application of continuous positive airway pressure (CPAP), patients who are using NHF oxygen therapy intermittently with Bi-level ventilation, patients who are receiving NHF oxygen therapy via a mask rather than nasal cannula, patients who are continuing NHF oxygen therapy in the ward after discharge from critical care or the emergency department, and patients in non-ward areas such as emergency care and critical care.
Outcome results
None listed