Health Condition 1: J962- Acute and chronic respiratory failure
Conditions
Interventions
Intervention1: Group A with Flow reduction strategy.: In Group A with Flow reduction strategy, flow will be gradually reduced by 10 L/min/hr. When it reaches 20 L/min, FiO2 reduction will then begin a
Sponsors
AIIMS Rishikesh
Eligibility
Inclusion criteria
Inclusion criteria: The patients on HFNC for AHRF and satisfying all of the following weaning criteria: 1. Age more than 18 years 2. No signs of respiratory distress (increased work of breathing, use of accessory muscles of respiration leading to diaphoresis, anxiety or agitation) 3. Arterial pH more than or equal to 7.35, SpO2 more than 90% on FiO2 less than or equal to 0.6 4. Respiratory rate less than 25/min, Heart rate less than 120/min, Systolic blood pressure more than or equal to 90 mmHg.
Exclusion criteria
Exclusion criteria: 1. Respiratory failure requiring or receiving endotracheal intubation or IMV during the current hospital stay. 2. Cardiac arrest, Acute Coronary Syndrome or life-threatening arrhythmias 3. More than or equal to 2 end organ failure other than respiratory failure defined as acute change in total SOFA score more than or equal to 2 points. 4. Patients with recent trauma or burns to the neck and face 5. Hypercapneic respiratory failure (pH less than 7.35 and PaCO2 more than 45)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Comparison of success rates of three weaning strategies (Flow reduction vs FiO2 reduction vs simultaneous reduction of flow and FiO2) by Chi-square test.Timepoint: Comparison of success rates of three weaning strategies by Chi-square test. Timeline : From start of weaning from HFNC till 48 hours off HFNC on conventional oxygen therapy via facemask/nasal cannula. | — |
Secondary
| Measure | Time frame |
|---|---|
| Analysis of patient comfort amongst three groups by comparison of mean comfort scores among three weaning strategies (Flow reduction vs FiO2 reduction vs simultaneous reduction of flow and FiO2) using one-way ANOVATimepoint: Time from weaning initiation to withdrawal of HFNC therapy.;Comparison of the average time taken to wean off high flow nasal cannula in the three weaning strategies (Flow reduction vs FiO2 reduction vs simultaneous reduction of flow and FiO2) using one-way ANOVATimepoint: Time from weaning initiation to withdrawal of HFNC therapy.;To compare the proportions of various adverse events amongst the three weaning strategies (Flow reduction vs FiO2 reduction vs simultaneous reduction of flow and FiO2) using Chi-square test.Timepoint: Time from weaning initiation to withdrawal of HFNC therapy. | — |
Countries
India
Contacts
Public ContactDr. Deepansh Gupta
AIIMS, Rishikesh
Outcome results
None listed