Chronic Obstructive Pulmonary Disease, COPD, COPD Exacerbation, Pneumonia, Respiratory Failure, Respiratory Insufficiency, Respiratory Tract Diseases
Conditions
Keywords
Non invasive ventilation, BiPAP, High-Flow Oxygen Therapy, High-Flow Nasal Cannula, COPD, Hypercapnia, Hypercapnic Respiratory failure, Chronic obstructive Pulmonary Disease
Brief summary
A retrospective cohort study of all patients treated for type II (hypercapnic) respiratory failure with either High-Flow Oxygen Therapy or Non-Invasive Ventilation in a general adult hospital.
Detailed description
We will compare various clinically relevant outcomes in patients treated for type II (hypercapnic) acute respiratory failure (ARF) with either High-Flow Nasal Cannula (HFNC) or Non-Invasive Ventilation (NIV) in a general adult hospital. All patients treated with HFNC were treated with an Optiflow device (Fisher&Paykel). Various Bilevel positive airway pressure (BiPAP) devices were used during the study period. All ventilatory parameters were set according to the treating physicians' preferences.
Interventions
DEVICENon-Invasive Ventilation
Treatment with Non-Invasive Ventilation by BiPAP. Different BiPAP models are in use. Ventilation parameters set at the discretion of the treating physician.
DEVICEHigh-Flow Nasal Cannula
Treatment with a High-Flow Nasal Cannula. The Optiflow device by Fisher&Paykel used in all cases. Flow and fraction of inspired oxygen (FiO2) parameters at the discretion of the treating physician.
Sponsors
Hôpital de Verdun
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients treated with respiratory failure not responding to conventional supplemental oxygen therapy * Blood venous gas showing partial pressure of carbon dioxide\>50 mmHg before beginning therapy with either NIV or HFNC
Exclusion criteria
* Lack of records of the primary outcome * End-of-life care * Lack of gas before the beginning of NIV or HFNC
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Failure of initial treatment (combined outcome) | 48 hours post intervention | Combined outcome of death or intubation or transition to another treatment modality or unplanned resumption of respiratory support |
| Death at 48h | 48 hours post intervention | Mortality in the 48h following the initial intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of stay | For the whole length of hospital stay, up to a maximum of one year. | Duration of stay in the hospital, in days |
| Mortality at 7d | 7 days post intervention | Incidence of death in the 7 days after intervention |
| Incidence of intervention change | For the whole length of hospital stay, up to a maximum of one year. | The incidence of patients who switch from Non-Invasive Ventilation to High-Flow Oxygen, and vice versa, due to treatment failure |
| Duration of endotracheal intubation | For the whole length of hospital stay, up to a maximum of one year. | Duration (in hours) of the first episode of endotracheal intubation, immediately following the failed intervention |
| Incidence of endotracheal intubation | For the whole length of hospital stay, up to a maximum of one year. | The incidence of intubation |
Countries
Canada
Outcome results
None listed