Pneumonia, Respiratory Failure
Conditions
Keywords
CPAP, HFNO
Brief summary
the study compares two non-invasive respiratory support modalities ie CPAP and High Flow nasal cannula oxygen for the treatment of severe hypoxemic respiratory failure attributed to Community acquired Pneumonia.
Detailed description
CPAP and High Flow nasal cannula oxygen are two established modalities for non-invasive respiratory support . In COVID pandemic era both CPAP and HFNO were widely used in the ward for the treatment of COVID-19 induced acute hypoxemic respiratory failure in order to prevent progression to intubation. Head to head comparison between the two modalities mentioned for the treatment of severe hypoxemic respiratory failure is not available neither in COVID pneumonia or Community acquired pneumonia (CAP).
Interventions
DEVICECPAP
CPAP will be delivered with a CPAP valve with venturi flow system with full-face mask. Treatment will start with CPAP set at 10cmH2O and FiO2 60% to target a SpO2 ≥90% or PO2 ≥60mmHg and then adjusted according to SpO2, respiratory distress and clinical tolerance
DEVICEHFNO
HFNO will be applied initially at maximal settings: 100% FiO2, flow rate 60 L/min and temperature 37C . Within 1 to 2 h, the HFNO settings should be titrated based on patients respiratory rate (\<25-30 per minute), SpO2 (92-96%) and comfort
Sponsors
University of Thessaly
Evangelismos Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients with age \>18 year old. * Been hospitalized with community acquired pneumonia * hospitalized in common ward (not ICU) * Patients should have pneumonia- pulmonary infiltrates in chest-xray and hypoxemic respiratory failure. * Patients should be unable to keep: SpO2\>93% with FiO2 50%, or SpO2 95% with FiO2 50% and have evidence of respiratory distress defined as Respiratory rate -RR\>35/min
Exclusion criteria
* Need for immediate or imminent intubation * not fit for escalation of treatment: defined as intubation, mechanical ventilation and ICU support. * Pregnant women * Contraindication to CPAP or HFNO
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| days free from ventilatory support | 28 days | days without support with either mechanical ventilation, HFNO, CPAP |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| intubation rate | 28 days | — |
| hospital mortality | 28 days | — |
| treatment failure defined | 28 days | no of patients that needed intubation and invasive mechanical ventilation or died |
| hospital length of stay | 28 days | — |
| Partial pressure of oxygen PaO2 change at 2h, 12h and 24h | 28 days | — |
| days under non-invasive respiratory support | 28 days | days without support with HFNO or CPAP |
Countries
Greece
Contacts
Primary ContactIOANNA SIGALA, PhD
Backup ContactIOANNIS KALOMENIDIS, PhD
Outcome results
None listed