Hypercapnic Respiratory Failure
Conditions
Keywords
respiratory failure, hypercapnia, BPAP, AVAPS
Brief summary
The aim of the present study; To compare the effects of respiratory support options available for NIMV at the emergency department; i.e. AVAPS and ST/T modes, on the patient's pCO2 values, additional treatment need (another non-invasive ventilation method or endotracheal intubation) and the duration of stay in hospital.
Detailed description
Non-invasive positive pressure ventilation (NIMV) is a life-saving procedure for patients with hypoxic and/or hypercapnic respiratory failure. AVAPS (average volume assured pressure support) is a noninvasive ventilation mode which has been developed to assure volume and pressure controlled respiratory support. AVAPS can ensure a constant tidal air volume to the patient with variable pressure support. Thus the positive features of the volume and pressure controlled support, which have a positive impact on the healing and recovery processes are combined. This study aims to compare, in a randomized order, BPAP ST/T and BPAP ST / T Mode with AVAPS, in patients with hypercapnic respiratory failure in the emergency department. Subjects: One hundred and two patients with hypercapnic respiratory failure will be included. Primary outcome; decrease in the PaCO2 values Secondary outcomes are stated as; Failure of treatment options, or change of the NIMV mode due to patient noncompliance or the patient's need for intubation and length of hospital stay (length of stay in the hospital from the emergency department).
Interventions
Sponsors
Dokuz Eylul University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
PaCO2 \> 45mmHg and any of the following * SaO2 \<90% on air * SaO2 \<93% on \>6 Litres O2/min * Inability to speak in sentences due to respiratory distress * Respiratory rate \> 24/min * Altered mental status * The use of accessory muscles of respiration
Exclusion criteria
* Respiratory arrest or unstable cardiorespiratory status * Suspected Pneumothorax * Urgent need for intubation * Systolic blood pressure \< 90 mmHg * Inability to protect airway * Facial deformity * Facial, esophageal, or gastric surgery history * All trauma patients * Acute myocardial infarction * Severe arrythmias * Refractory nausea and vomiting
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PaCO2 values | On arrival, at one hour, and at two hourly intervals thereafter | Will measure change in PaCO2 values in the blood gase analysis of patients comparing those treated with BPAP ST/T and those with AVAPS |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Failure of treatment options | During the treatment | Change of the NIMV mode due to patient noncompliance (switching to the second mode) or the patient's need for intubation during the treatment |
| Length of hospital stay | up to 6 months | Length of hospital stay in the hospital (From the emergency department admission) |
| The time of treatment | During the treatment | The sum of the noninvasive ventilation time in the emergency department. |
Countries
Turkey (Türkiye)
Outcome results
None listed