Respiratory Failure
Conditions
Keywords
HFNC, Respiratory Failure, Intubation, Mortality
Brief summary
Respiratory failure is the danger for the patients admitted in ICU, mechanical ventilation could save a lot of patients' life, however, it prolongs patients' ICU stay and hospital stay. High flow nasal cannula (HFNC) has advantages of PEEP effects, reducing dead space, increasing EELV and improving comfort, and it has been used to treat respiratory failure patients. In recent study, HFNC could improve mortality of respiratory failure patients with P/F\<200mmHg in the subgroup. The investigators want to start a randomized controlled study to evaluate the effects of HFNC on the patients with respiratory failure.
Detailed description
just as the brief summary
Interventions
DEVICEHFNC
patients treated with high flow nasal cannula
DEVICENIV
patients treated with noninvasive ventilation
Sponsors
First Affiliated Hospital of Suzhou Medical College
Second Affiliated Hospital of Suzhou University
Zhangjiagang First People's Hospital
The Second Hospital of Nanjing Medical University
Wuxi No. 4 People's Hospital
Southeast University, China
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Age\>18 years 2. patients met all four of the following criteria: * a respiratory rate of more than 25 breaths per minute, * a ratio of the partial pressure of arterial oxygen (Pao2) to the Fio2 of 300 mm Hg or less while the patient was breathing oxygen at a flow rate of 10 liters per minute or more for at least 15 minutes, * a partial pressure of arterial carbon dioxide (Paco2) not higher than 45 mmHg, and * an absence of clinical history of underlying chronic respiratory failure
Exclusion criteria
1. Paco2 of more than 45 mm Hg 2. exacerbation of asthma or chronic respiratory failure 3. cardiogenic pulmonary edema 4. severe neutropenia 5. hemodynamic instability, use of vasopressors, 6. Glasgow Coma Scale score of 12 points or less (on a scale from 3 to 15, with lower scores indicating reduced levels of consciousness) 7. contraindications to noninvasive ventilation 8. urgent need for endotracheal intubation, a do-not-intubate order, and a decision not to participate.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| intubation rate on 28 days | up to 28 days |
Secondary
| Measure | Time frame |
|---|---|
| Duration of ICU stay | date of death from any cause, whichever came first, assessed up to 90 days |
| Duration of hospital stay | date of death from any cause, whichever came first, assessed up to 90 days |
Outcome results
None listed