Extubation, High-Flow Nasal Oxygen Therapy, ICU, Non-invasive Ventilation, Respiratory Effort, Tidal Volume, Work of Breathing
Conditions
Brief summary
This study is aimed at evaluating patient work of breathing and tidal volumes with three methods of oxygenation: standard oxygen, high-flow oxygen therapy and non-invasive ventilation.
Interventions
DEVICEHigh-Flow Nasal Oxygen / Non-invasive ventilation / Standard oxygen
Device High Flow Nasal Oxygen: gas flow of 50L:Min and FiO2 adjusted to obtain SpO2\>= 92% Device NIV: Pressure-support level to achieve an expired tidal volume between 6 and 8 ml/kg and PEEP level of 5 cmH2O and FiO2 adjusted for SpO2\>= 92%
Sponsors
Poitiers University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Minimum age: 18 years * planned extubation decided by the physician in charge of the patient after success of weaning trial * patients at high risk of reintubation according to the following criteria: patient older than 65 years, or those having any underlying chronic cardiac or lung disease * Hypoxemia defined by PaO2/FiO2 \< 300 mmHg under mechanical ventilation before extubation
Exclusion criteria
* Duration of mechanical ventilation prior to extubation \< 24h * Contraindication to NIV * Contraindication to nasogastric tube * Do-not-reintubated order at time of extubation * People under legal protection * Opposition to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient respiratory effort and tidal volume (Vt) | 1h20 | Swing of oesophageal pressure and pressure-Time product measured by a nasogastric pressure sensor tidal Volume estimated by electric impedance tomography |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory parameters | Time 0,Time 20 min, Time 40 min, Time 60 min, Time 120 min | respiratory rate (FR bt/min) |
| Hemodynamic parameters | Time 0,Time 20 min, Time 40 min, Time 60 min, Time 120 min | Systolic arterial pressure (PAS in mmHg), Diastolic arterial pressure (PAD in mmHg) |
| Comfort evaluation | Time 0,Time 20 min, Time 40 min, Time 60 min, Time 120 min | comfort evaluation with an visual evaluation scale graduate 0 cm (No discomfort) to 10 cm (maximal discomfort) |
Countries
France
Contacts
Primary ContactArnaud W. THILLE, PUPH
Backup ContactCéline DELETAGE
Outcome results
None listed