High Flow Nasal Cannula, Respiratory Insufficiency
Conditions
Keywords
high flow nasal cannula, weaning, adult
Brief summary
High flow nasal cannula oxygen therapy has been widely used in critically ill patients. Despite effectiveness of high flow nasal cannula as a treatment, optimal methods to withdrawal high flow nasal cannula after recovery from preexisting conditions has not been investigated to date. In this study, we will evaluate the efficacy and safety of three different weaning methods in patients with high flow nasal cannula oxygen therapy.
Detailed description
Comparison of three weaning strategies: flow reduction first versus fraction of inspired oxygen (FiO2) first versus simultaneous reduction
Interventions
DEVICEFlow reduction first
-10L/min q 1hr
DEVICEFiO2 reduction first
\- 0.1 q 1hr
DEVICESimultaneous (flow and FiO2) reduction
-10L/min and -0.1 q 1hr
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The patients applying high flow nasal cannula and satisfying the following weaning criteria. 1. Patient who has recovered from the underlying condition 2. No signs of respiratory distress like agitation, diaphoresis or anxiety 3. Arterial pH ≥ 7.35, SpO2 \> 90% on FiO2 ≤ 0.5 4. Respiratory rate ≤ 25/min, Heart rate ≤120/min, Systolic blood pressure ≥ 90mmHg
Exclusion criteria
* Severe hypercapnia (pH \<7.25) * Respiratory arrest requiring tracheal intubation * Cardiac arrest, acute coronary syndrome or life threatening arrhythmias * Failure of more than two organs * Recent trauma or burns of the neck and face * Non- cooperation * Pregnancy * Refusal of treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to weaning success | up to 2 weeks | The time to successfully remaining off high flow nasal cannula |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| weaning success or failure rate | up to 2 weeks | Success or failure rate to wean off high flow nasal cannula |
| change of arterial partial pressure of oxygen, carbon dioxide, and pH | up to 2 weeks | changes of arterial blood gas analyses |
| intolerance rate | up to 2 weeks | intolerance to high flow nasal cannula |
| hospital length of stay | during hospital admission, up to 12 weeks | hospital length of stay |
| In-hospital mortality | during hospital admission, up to 12 weeks | all cause mortality |
Countries
South Korea
Outcome results
None listed