Prehospital CPAP vs. Usual Care for Acute Respiratory Failure

Prehospital CPAP Versus Usual Care for Acute Respiratory Failure: a Randomized Controlled Trial

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT00405314

Enrollment

Registered

2006-11-30

Start date

2002-07-31

Completion date

2006-03-31

Last updated

2016-06-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hypoxia, Respiratory Insufficiency

Keywords

respiratory failure, non invasive ventilation, prehospital, endotracheal intubation, continuous positive airway pressure

Brief summary

The purpose of this study is to evaluate the effectiveness of continuous positive airway pressure ventilation when applied by paramedics to individuals with severe breathing difficulties in the prehospital setting.

Detailed description

Continuous positive airway pressure ventilation (CPAP) has been shown to be effective in avoiding endotracheal intubation (ETI) for patients with acute respiratory failure in hospital but despite several case series, the effectiveness of the prehospital application of CPAP by paramedics has not been studied in a randomized fashion. We performed a prospective, randomized, non blinded trial to determine whether patients in acute respiratory failure treated with CPAP in the prehospital setting had lower overall ETI rates than those treated with standard care.

Interventions

DEVICEContinuous positive airway pressure ventilation mask

Study design

Allocation

RANDOMIZED

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

16 Years to No maximum

Healthy volunteers

Inclusion criteria

* severe dyspnea * respiratory rate \>25 breaths/minute * hemodynamically stable * able to cooperate with ventilatory support measures * assessed by paramedics as being in urgent need of ETI and/or manual positive pressure ventilation * a trip destination of the QEII Health Sciences Center or Dartmouth General Hospital

Exclusion criteria

* require ETI for immediate airway protection * respiratory rate \< 8 breaths/minute * evidence of hemodynamic instability * cardiac ischemia * any chest pain within 3 hours of presentation * valid do not resuscitate advanced directive * an inadequate supply of portable oxygen

Design outcomes

Primary

Measure	Time frame
proportion of patients in each group endotracheally intubated prior to hospital discharge or death	—

Secondary

Measure	Time frame
critical care unit length of stay	—
mortality	—
hospital length of stay	—

Countries

Canada

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026