Chronic Obstructive Pulmonary Disease
Conditions
Brief summary
The objective of this study is to test the effect of High Molecular Weight Hyaluronic Acid (HMW-HA) on Non Invasive Ventilation (NIV) effectiveness in patients admitted to a sub-intensive care unit for respiratory failure due to acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).
Detailed description
The objective of this study is to test the effect of HMW-HA on NIV effectiveness in patients admitted to a sub-intensive care unit for respiratory failure due to acute exacerbation of COPD. The design is a parallel-arm, single-blind, placebo-controlled randomized clinical trial. Eighty patients, aged eighteen years or older, admitted for respiratory failure primarily due to COPD exacerbation and requiring non-invasive ventilation will be enrolled and randomized to the study treatment (active or placebo). All patients will be treated with NIV delivered using a Hamilton C1 ventilator and medical therapy according to current guidelines (inhaled long-acting b2 agonists, inhaled long-acting anticholinergic, inhaled and systemic corticosteroids, antibiotics). Patients randomized to the active intervention group will also receive HMW-HA (Yabro® - 5 ml of saline containing 0.3% hyaluronic acid sodium salt) via nebulizer b.i.d., while patients randomized in the control group will receive a matching placebo. Patients will be treated until weaning or until NIV failure, defined as oro-tracheal intubation or death.
Interventions
Aerolized administration b.i.d.
Standard therapy
Sponsors
Study design
Eligibility
Inclusion criteria
* Aged 18 years of age or older * Admitted for respiratory failure primarily due to COPD exacerbation * Requiring non-invasive ventilation * Respiratory distress, as evidenced by moderate-to-severe dyspnea and use of accessory muscles of respiration * Hypercapnic respiratory failure * High respiratory rate
Exclusion criteria
* Respiratory arrest or the need for immediate intubation * Upper airways obstruction * Facial trauma * Inability to cooperate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cumulative time on NIV | Day 1-10 | Cumulative duration of NIV in hours during the enrollement |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of decline of time on NIV | Day 1-10 | rapidity of weaning from NIV |
Other
| Measure | Time frame | Description |
|---|---|---|
| Indices of NIV efficacy over one week of treatment | 7 days | measures of effectiveness of ventilation in a week of treatment |
Countries
Italy