Acute Respiratory Failure With Hypercapnia
Conditions
Brief summary
The purpose of this study is to determine the impact of hign-flow nasal therapy on the adult with hypercapnia and hpoxemia respiratory faliure in comparison with standard oxygen therapy ang noninvasive ventilation.
Detailed description
Humidified high flow nasal oxygen therapy decreases dilution of the inhaled oxygen and, by matching patient's peak flow, allows accurate delivery of the set FiO2 throughout the whole inspiratory phase.The purpose of this study is to determine the impact of hign-flow nasal therapy on adult hypercapnic respiratory failure by comparing with nasal continuous positive airway pressure
Interventions
OTHERstandard low flow therapy
In the standard low flow therapy oxygen group, oxygen at a flow rate of 10 liters per minute or more.
The patient will receive high flow nasal of humidified oxygen, set between 30 to 60 l/min. The inspired fraction of oxygen (FiO2) will be adjusted in order to obtain a SpO2 \>92%.
DEVICEassociation of high flow nasal oxygen therapy and non invasive positive pressure ventilation
The patient will receive successively in a day NPPV and O2-HFN. The NPPV will be applied with an airway humidification achieved by using a heated humidifier and a facial mask adapted to the morphology of the patient. The settings will be adjusted as follow : an inspiratory pressure between 6 to 14 cmH2O, in order to obtain a tidal volume between 7 to 10 ml/kg of predicted weight, a positive expiratory pressure between 0 to 10 cmH2O in order to obtain a SpO2 \>92% with the minimal FiO2.
Sponsors
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Hypoxemic and no hypercapnic acute respiratory failure : * severe dyspnea at rest with a respiratory rate \>25 breaths/min * PaO2/FiO2 \<300 * PaCO2 \<45 mmHg,
Exclusion criteria
* age \<18 years * NPPV contraindications * past history of respiratory chronic disease (COPD, cystic fibrosis…) * cardiac pulmonary edema * Pre-defined intubation * other than respiratory organ failure : systolic pressure \<90 mmHg,current treatment with epinephrine or norepinephrine, decreased level of consciousness ( Glasgow score ≤ 12) * profound aplasia (white cells count \<1000/mm 3)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the number of patients in each group who require endotracheal intubation with mechanical ventilation | 28days | To compare the number of patients in each group who require endotracheal intubation with mechanical ventilation |
Secondary
| Measure | Time frame |
|---|---|
| mechanical ventilation-free to day 28 | 28 days |
Countries
China
Contacts
Primary Contactbin he
Backup Contactdongjuan tang
Outcome results
None listed