Acute Respiratory Failure
Conditions
Brief summary
Respiratory failure patients sometimes receive tracheostomy due to difficulty weaning from mechanical ventilation. Efforts to wean patients with a tracheostomy usually involve the administration of oxygen via High Humidity device. There are two major ways of administering oxygen to patients which include low flow delivered at less than 10Liters per minute (LPM) and high-flow delivered at greater than 10LPM. There is not a currently accepted standard of care practice for how to administer oxygen therapy to these patients. Both Low and High Flow are accepted practices in the US.
Detailed description
Many patients with Respiratory Failure undergo tracheostomy due to difficulty weaning from mechanical ventilation. A component of weaning a patient with tracheostomy usually involves the administration of oxygen via High Humidity device. There are two major ways of administering oxygen via High Humidity to patients. They include low flow high humidity; delivered at less than or equal to 10LPM or high-flow humidity, delivered at greater than 10LPM. There is not a currently accepted standard of practice for how to administer oxygen high humidity to patients who receive a tracheostomy due to respiratory failure. Both Low and High Flow high humidity devices are used routinely by health care facilities nationwide. Therefore, the investigators plan to perform a crossover study in both a medicine and surgical Intensive Care Unit to determine which type of oxygen High Humidity therapy should be preferentially utilized. Patients in one Intensive Care Unit will start off with Low Flow high humidity while the alternate unit will start with Hi Flow high humidity. After one half of the required sample size is accrued the investigators will cross over the two ICUs to the alternate type of oxygen High Humidity device. No other respiratory practices will change during the conduct of this trial.
Interventions
High Flow High Humidity device has a flow generator built into the body of unit and can deliver flows between 10 to 60 Liters per minute (LPM) with oxygen bled in as needed in order to deliver specified Fraction of inspired Oxygen (FiO2)
Standard high humidity trach collar utilizing venturi device bleed in
Sponsors
Study design
Masking description
Single blind
Intervention model description
Crossover study between 2 medical ICUs and 1 Surgical ICU. Patients in one unit will start off with Low Flow (LF) while the other unit will start off with High Flow (HF). After one half of the required sample size is accrued we will crossover the Medicine ICUs with the Surgical ICU.
Eligibility
Inclusion criteria
* Mechanically ventilated patients who receive tracheostomy
Exclusion criteria
* Non-English speaking and pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Days of Mechanical Ventilation (MV) | an average of 1 year | Time in days from initiation of MV until discontinuance of MV |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Days of ICU Stay | an average of 1 year | The number of days the subject is in the ICU |
| Days of hospital stay | an average of 1 year | Time in days from admission to hospital until discharge from hospital |
Countries
United States