Re-intubation Rate, Respiratory Failure
Conditions
Brief summary
This is study aim to compare between high flow nasal canula (HFNC) and non invasive positive pressure ventilation (NIPPV) in reducing the rate of reintubation in mechanically ventilated patient with successful weaning
Detailed description
* High-flow nasal cannula (HFNC) oxygen therapy comprises an air/oxygen blender, an active humidifier, a single heated circuit, and a nasal cannula. It delivers adequately heated and humidified medical gas at up to 60 L/min of flow and is considered to have a number of physiological effects: reduction of anatomical dead space, positive end expiratory pressure ( PEEP ) effect, constant fraction of inspired oxygen, and good humidification * Noninvasive positive-pressure ventilation is a safe and effective means of improving gas exchange in patients with many types of acute respiratory failure . for example, adding noninvasive ventilation to standard therapy decreased the need for endotracheal intubation...For patients assigned to noninvasive ventilation, the ventilator was connected with conventional tubing to a clear, full-face mask with an inflatable soft-cushion seal and a disposable foam spacer to reduce dead space .After the mask had been secured, pressure support was increased to achieve an exhaled tidal volume of 8 to 10 ml per kilogram, a respiratory rate of fewer than 25 breaths per minute, the disappearance of accessory muscle activity (as evaluated by palpation of the sternocleidomastoid muscle), and patient comfort * The effects of high-flow nasal cannula (HFNC) on adult patients with acute respiratory failure (ARF) are controversial. The investigators aimed to further determine the effectiveness of HFNC in reducing the rate of endotracheal intubation in adult patients with ARF by comparison to noninvasive positive pressure ventilation (NIPPV)
Interventions
DEVICEhigh flow nasal cannula
device are used for weaning patients after mechanical ventilation extubation
device are used for weaning patients after mechanical ventilation extubation
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
When the patient become weanable from mechanical ventilation, the subjects were extubated immediately and randomly divided into two groups, with one group receiving HFNC (called HFNC group), the other group receiving NIPPV (called NIPPV group)
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
Yes
Inclusion criteria
* All patient suffer from acute respiratory failure and intubated for mechanical ventilation and then extubated for weaning * Age \>18 years old
Exclusion criteria
* In patients less than 18 years old * Any contradiction in using HFNC as trauma or surgery or obstruction of nasopharynx * Any contradiction in using NIPPV as facial trauma ..surgery ..deformity..or upper airway obstruction or upper gastrointestinal bleeding or high risk of aspiration
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the need for re-intubation and weaning success which will be measured by arterial blood gas ( ABG ) | baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of using of HFNC or NIPPV | up to 30 days | — |
| Length of hospital stay measured by days | up to 30 days | — |
| In - hospital mortality measured by number of died cases | up to 30 days | — |
| Adverse events | up to 30 days | Adverse events (occurrence of nosocomial pneumonia based on clinical and laboratory and radiological finding, need for MV measured by re-intubation rate) |
| Incidence of any possible complications associated with the use of HFNC and NIPPV | up to 30 days | — |
Contacts
Primary Contactmohamed osman shehata abdelkareem, resident doctor
Backup ContactMaha Kamel Ghanem, professor
Outcome results
None listed