Acute Respiratory Failure
Conditions
Keywords
Single breath counting test, Acute Respiratory Failure
Brief summary
The purpose of the study is to determine whether SBCT is a useful tool for diagnosing the main form of failure respiratory acute and to define the SBCT limit associated with insufficiency respiratory in this population, the requirement for NIV or invasive ventilation. Furthermore, the correlation with the most common scores and indices used in the emergency room will be studied, such as: HACOR, MEW, REMS SCORE, ROS, CURB-65, qSOFA, SEVERITY INDEX OF PNEUMONIA, GWTG HF, LUNG ULTRASOUND SCORE, SINGLE BREATH COUNT
Detailed description
Single breath counting test (SBCT) is the measurement of how far an individual can count in a normal speaking voice after a maximal effort inspiration. Previous work has demonstrated that SBCT has good correlation with the gold standard measures of pulmonary function test, peak expiratory flow rate and forced expiratory volume in the first second. The easy of the SBCT makes this test appealing for rapid assessment of respiratory status overall in patients admitted for acute respiratory failure and we hypothesized that it will be valuable, replicable and fast tools for bedside assessment of respiratory function in Emergency Department. The purpose of the study is to determine whether SBCT is a useful tool for diagnosis of the major form of acute respiratory failure and to define the cut-off limit of SBCT associated to respiratory failure in this population, requirement of NIV or invasive ventilation. Moreover, it will be studied the correlation with the most common scores and indexes used in emergency department like: HACOR, MEW, REMS SCORE, ROS, CURB-65, qSOFA, PNEUMONIA SEVERITY INDEX, GWTG-HF, LUNG ULTRASOUND SCORE, SINGLE BREATH COUNTING TEST
Interventions
PROCEDUREOxygen Therapy
Patients who have SpO2 \< 92% on room air will undergo oxygen therapy (nasal cannula or Venturi-mask).
PROCEDURENon-Invasive Ventilation (NIV)
Patients with P/F \< 250 or Ph \< 7,35 with PCO2 \> 50 mmHg will undergo Non-Invasive Ventilation (NIV) (high flow nasal cannula or CPAP).
PROCEDUREInvasive Ventilation
Patients with P/F \< 150 associated to dyspnea at rest (moderate to severe, shortness of breath and/ or tachypnea (\>24 breaths/min) despite NIV for at least 2 hours or patients with Ph \< 7,2 with PCO2 \> 60 mmHg despite NIV for at least 2 hours will undergo invasive ventilation (intubation).
Sponsors
Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo di Alessandria
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 110 Years
Healthy volunteers
No
Inclusion criteria
* Any Acute Respiratory Failure * SaO2 \<92% on air room at ED admission
Exclusion criteria
* Age \< 18 yo * Patients already in NIV AND HCFN in ED * Home-oxygen or Home-NIV therapy * SpO2 \< 80% * Severe dyspnea * unable to speak complete sentences * Uncooperative patients * Hemodynamic Instability \< 90 mmHg or vasopressor requirement at admission * ST Elevation-Miocardial Infarction * Tracheo -stomized or -tomized patients * End of life
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Single Breath Counting Test (SBCT) | Change from Baseline at 3 hours | Determine if SBCT is a useful, fast and reproducible tool for assessing respiratory failure and its severity in the Emergency Department. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation with the main critical illness scores | Change from Baseline at 3 hours | Define the correlation of SBCT with the main critical illness scores |
| Correlation with the main serum markers | Change from Baseline at 3 hours | Define the correlation of SBCT with the main serum markers corresponding to the underlying respiratory failure disorder |
| Correlation with imaging | Change from Baseline at 3 hours | Define the correlation of SBCT with radiographic (infiltrated) and ultrasound imaging |
| SBCT as predictor NIRS | Change from Baseline at 3 hours | Define if Single Breath Counting Test (SBCT) could be a predictor of Non-Invasive Respiratory Strategies (NIRS) |
| Cut-off limit to initiate appropriate respiratory support | Change from Baseline at 3 hours | Define the cut-off limit to initiate appropriate respiratory support |
| Correlation with Emergency Room Mortality | Change from Baseline at 3 hours | Define the correlation of SBCT with Emergency Room Mortality |
| Correlation between pulmonary and extrapulmonary causes | Change from Baseline at 3 hours | Correlation between pulmonary and extrapulmonary causes |
| Cut-off limit of SBCT | Change from Baseline at 3 hours | Define the cut-off limit, the sensitivity and the specificity of SBCT associated with respiratory failure |
Countries
Italy
Contacts
Primary ContactClinical Trial Center
Outcome results
None listed