Acute Hypoxemic Respiratory Failure
Conditions
Keywords
Acute hypoxemic respiratory failure, Preoxygenation, Crash induction
Brief summary
Oro-tracheal intubation in intensive unit care(ICU) in acute hypoxemic respiratory failure after crash induction remains a critical event. The aim of this study is to determine whether Nasal High Flow Therapy (HFT) Optiflow ® is more efficient than the face mask for preoxygenation before orotracheal intubation after crash induction in acute hypoxemic respiratory failure
Detailed description
This study will be designed as followed : Patients will be randomized in 2 groups :PREOXYFLOW or STANDARD FACE MASK. Patients randomized in PREOXYFLOW group will received a four minutes preoxygenation period with Nasal High Flow Therapy (HFT) (60 l/mn FIO2 = 1) before orotracheal intubation under laryngoscopy after crash induction. Patients randomized in STANDARD FACE MASK group will received a four minutes preoxygenation period with standard face mask (15 l/mn) before orotracheal intubation under laryngoscopy after crash induction
Interventions
DEVICEPREOXYFLOW
Patients randomized in PREOXYFLOW group will received a four minutes preoxygenation period with Nasal High Flow Therapy (HFT) Optiflow ® (60 l/mn FIO2 = 1) before orotracheal intubation under laryngoscopy after crash induction
PROCEDURESTANDARD FACE MASK
Patients randomized in STANDARD FACE MASK group will received a four minutes preoxygenation period with a standard face mask (15 l/mn) before orotracheal intubation under laryngoscopy after crash induction. Each hospital involved in this study will use the standard face mask as per its usual practice (no specific trademark requested by this protocol)
Sponsors
Nantes University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults older than 18 years regardless of the gender * Acute hypoxemic respiratory failure defined as : Respiratory rate \> 30/mn AND Hypoxemia with SpO2 \<90% with oxygen supply \> FiO2 0,5 AND PaO2/FiO2 \<300 mmHg
Exclusion criteria
* Contraindication to oro-tracheal intubation * Intubation without anesthetic delivery * Intubation during cardiac arrest * Asphyxia with immediate intubation needed * Nasopharyngeal obstacle with contraindication to use Optiflow device * Patients with a documented Cormack IV exposition before inclusion * Protected adult * Pregnancy * Lack of consent * Patient already enrolled in an other randomized study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| to determine whether Optiflow® used during the preoxygenation period before orotracheal intubation after crash induction is more efficient than standard face mask. | 4 minutes | This outcome will be assessed from the beginning of the preoxygenation period to the end of orotracheal intubation by monitoring the pulse oxymetry |
Secondary
| Measure | Time frame |
|---|---|
| Improvement of quality of preoxygenation | 4 minutes |
| Reduction in side effects incidence related to intubation | 1 hour |
| Reduction in Organ failure in the 5th day | at day 5 |
| Reduction in morbi-mortality during the Intensive Care Unit stay. | until day 28 OR, if patient still in the intensive care unit (ICU) at Day 28, until discharge of ICU |
Countries
France
Outcome results
None listed