Acute Respiratory Failure, High Flow Nasal Cannula, Critically Ill, Airway Disease, Positive End Expiratory Pressure, Diaphragm Disease
Conditions
Keywords
intensive care unit, critically ill patient, high flow nasal cannula, PEEP, respiratory failure, non invasive ventilation
Brief summary
High flow nasal cannula administration in critically ill patients is frequently used to improve acute respiratory failure or to prevent respiratory failure after extubation. It acts generating a mild positive pressure in the airways and by reducing respiratory effort of patients. However to the best of our knowledge, no study to date has directly measured the amount of positive pressure generated in the trachea of patients. The primary aim, therefore, of this study measures this positive pressure after extubation in critically ill patients.
Interventions
DEVICEHIGH FLOW NASAL OXYGEN
BEFORE EXTUBATION, AN AIRWAY EXCHANGE CATHETER (AEC) WILL BE PUT INTO THE PATIENTS' TRACHEA AND IT WILL REMAIN IN SITE AFTER EXTUBATION. THROUGH AN AEC CONNECTED TO A PRESSURE MONITOR, IT WILL BE RECORDED TRACHEAL PRESSURE DURING SPONTANEOUSLY BREATHING PATIENT AT DIFFERENT FLOW RATES OF HFNC THAT WILL BE APPLIED JUST AFTER EXTUBATION. MEANWHILE, VITAL PARAMETERS RECORDED WITH A MULTIPARAMETRIC MONITOR WILL BE RECORDED. FINALLY, MONITORING OF ELECTRICAL ACTIVITY OF DIAPHRAGM WILL BE RECORDED THROUGH A DEDICATED NASOGASTRIC TUBE TO EVALUATE IT AT DIFFERENT FLOW RATES.
Sponsors
Azienda Sanitaria-Universitaria Integrata di Udine
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
CRITICALLY ILL PATIENTS AFTER MECHANICAL VENTILATION LASTED AT LEAST 72 HOURS * age 18-80 years
Exclusion criteria
* COPD stage \>1 according to GOLD classification * end stage organ disease (liver, kidney, heart, lung) * neuromuscular disease * neoplasm * previous tracheostomy * obesity with BMI \> 35 Kg/m2 * non collaborative patient
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HFNC-PEEP | 3 HOURS | THE LEVEL OF POSITIVE AIRWAY PRESSURE GENERATED BY DIFFERENT FLOW RATES OX OXYGEN WILL BE RECORDED. FLOW RATE STARTS AT 10 L/MIN AND IT WILL BE INCREASED A 10 L/MIN STEP EVERY 30 MINUTES UNTIL 60 L/MIN. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| HFNC-EADI | 3 HOURS | ELECTRICAL ACTIVITY OF THE DIAPHRAGM WILL BE RECORDED THROUGH A DEDICATED NASOGASTRIC TUBE DURING ALL THE PROCESS. FLOW RATE STARTS AT 10 L/MIN AND IT WILL BE INCREASED A 10 L/MIN STEP EVERY 30 MINUTES UNTIL 60 L/MIN. |
Countries
Italy
Contacts
Primary ContactCristian Deana, MD
Outcome results
None listed