Chronic Obstructive Pulmonary Disease Patients, Chronic Respiratory Failure
Conditions
Brief summary
Chronic hypercapnic respiratory failure is common in stable COPD patients in a terminal phase of their disease In an attempt to correct or slow down the rate of rise of PaCO2, long-term noninvasive mechanical ventilation (NIV) has been proposed. Only very few studies demonstrated the clinical efficacy of NIV. Indeed this technique is not always well tolerated and therefore it may be effective only in a subset of patients The aim of this study is to assess the feasibility and safety of one shot extrcorporeal CO2 removal device, in reducing the PaCO2 level
Detailed description
Chronic hypercapnic respiratory failure is common in stable COPD patients in a terminal phase of their disease In an attempt to correct or slow down the rate of rise of PaCO2, long-term noninvasive mechanical ventilation (NIV) has been proposed. Only very few studies demonstrated the clinical efficacy of NIV. Indeed this technique is not always well tolerated and therefore it may be effective only in a subset of patients Recently extracorporeal CO2 removal have been shown to avoid the need of endotracheal intubation in COPD patients with an episode of Acute Hypercapnic Respiratory Failure In this pilot physiological study we want to assess the safety and efficacy of this technique in reducing the PaCO2 level in those COPD patients with chronic hypercapnic respiratory failure non responding to chronic NIV.
Interventions
An ECCO2R device based on a modified continuous venovenous hemofiltration system will be used
Sponsors
Study design
Eligibility
Inclusion criteria
* COPD ( FEV1/CVF \<0.70 post bronchodilation) * stable PaCO2 \>55 mmHg non respondent to long-term NIV (at least one week). This means a decrease in PaCO2 during spontaneous breathing, at least 4 hrs after the termination of NIV, of\< 6% * pH \> 7.35 * clinical stability
Exclusion criteria
* Mean Arterial Pressure \< 60 mmHg * contra-indication to heparin * Body Mass Index (BMI) \> 30 kg/m2; * presence of sleep apnea or overall syndrome
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| arterial blood gases | 30 days |
Secondary
| Measure | Time frame |
|---|---|
| respiratory rate, dyspnea | 30 days |
Countries
Italy