Respiratory Failure
Conditions
Keywords
Bronchoscopy, Intubation, Noninvasive positive pressure ventilation
Brief summary
This study is to investigate the efficiency and safety of fibreoptic bronchoscopy assisted intubation during noninvasive positive pressure ventilation in respiratory failure patients. Half of the participants will receive preoxygenation with noninvasive ventilator and fibreoptic bronchoscopy intubation during NIPPV. While the other half using usual preoxygenation(bag-mask ventilation ).
Detailed description
Respiratory failure is very common for critically ill patients, Main complication associated with intubation was desaturation. Usual preoxygenation( bag-mask ventilation) have been show that marginally effective in critically ill patients. As a result, there is a need to optimize the technique of preoxygenation to prolong the safe duration of apnea during the intubation procedure in critically ill patients. Noninvasive ventilation provides continuous positive airway pressure is effective in increasing the efficiency of gas exchange and in reducing the decrease in oxyhemoglobin saturation during fiberoptic bronchoscopy in hypoxemic patients. Therefore, our aim was to study whether NIPPV is more effective at reducing desaturation than usual preoxygenation in hypoxemic, critically ill patients requiring intubation in ICU.
Interventions
The control group receives preoxygenation with bag-mask ventilation
The NIPPV group receives noninvasive positive pressure ventilation during fibreoptic bronchoscopy assisted intubation
All patients will receive fibreoptic bronchoscopy assisted intubation.
Sponsors
Study design
Eligibility
Inclusion criteria
* Acute respiratory failure requiring intubation, * Age greater than or equal to 18 years
Exclusion criteria
1. Nasal polyps,Nasopharyngeal cancer,Nasal bleeding,Rhinitis,Sinusitis and so on Nasal disease 2. Basal skull fracture 3. Severe coagulopathy, blood platelet counts \<50×10\*9/L 4. Nose and facial deformities, trauma 5. Cardiac arrest 6. Pregnancy or puerpera
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in pulse oxymetry(SpO2) | From time of randomization until connect to ventilator 30min |
Secondary
| Measure | Time frame |
|---|---|
| Mechanical ventilation Time | 28 days |
Other
| Measure | Time frame |
|---|---|
| 28 days survival rate | From the day of intubation to 28 days |
Countries
China