Acute Respiratory Failure, High Flow Oxygen Therapy, Hypoxemic Acute Respiratory Failure, Oxygen Delivery
Conditions
Brief summary
Several factors can influence oxygenation monitoring and respiratory support through oxygen therapy: the type of oximeter used, skin pigmentation, and the oxygenation target. It is essential to have an accurate measurement of SpO2 in order to optimize the flow of oxygen or FiO2 administered to patients. The question arises as to the impact of these confounding factors on the FiO2 set during high-flow nasal oxygen therapy. The aim of the study is to evaluate the impact of the oxygenation target and the oximeter used on FiO2 in patients receiving high-flow nasal oxygen therapy.
Detailed description
The oximeters evaluated will be the Nonin (Plymouth, MN) and the Philips (Eindhoven, Netherlands). Two SpO2 targets will be evaluated: 90% and 94%. A total of four 10-minute periods will be performed in randomized order: Nonin 90, Nonin 94, Philips 90, and Philips 94. At the end of each 10-minute period, arterial gas will be collected through the arterial catheter.
Interventions
DEVICEManual FiO2 titration with Philips oximeter (SpO2 target 90%)
FiO2 titration to reach the SpO2 target (set at 90%) with Philips oximeter
DEVICEManual FiO2 titration with Nonin oximeter (SpO2 target 90%)
FiO2 titration to reach the SpO2 target (set at 90%) with Nonin oximeter
DEVICEManual FiO2 titration with Philips oximeter (SpO2 target 94%)
FiO2 titration to reach the SpO2 target (set at 94%) with Philips oximeter
DEVICEManual FiO2 titration with Nonin oximeter (SpO2 target 94%)
FiO2 titration to reach the SpO2 target (set at 94%) with Nonin oximeter
Sponsors
Laval University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ≥ 18 years of age * Admiitted in intensive care unit * Presence of an arterial catheter * Ongoing on high flow nasal oxygen therapy with SpO2 between 88 and 100% with a FiO2 between 40 and 80% with the usual oximeter .
Exclusion criteria
* No SpO2 signal with oximeter in use * False nails or nail polish * Methemoglobinemia \>0.015 on last available arterial gas * Patient in isolation (multi-resistant bacteria, C-Difficile, SARS-CoV-2 ...) * Expected to use another respiratory support within two hour of inclusion (NIV or mechanical ventilation)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| FiO2 | Mean FiO2 in the two last minute of each study period between minute 8 and 10 | FiO2 at the end of each study period (last minute average) to reach SpO2 target to reach SpO2 target with specific oximeter |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Difference between SpO2 and SaO2 | assessed up to 10 minutes - at the same of the arterial blood gases punction | Difference (%) between SpO2 from each oximeter and SaO2 (% of SaO2 overestimation and underestimation for each oximeter) |
| High flow weaning criteria | Mean FiO2in the two last minute of each study period (between minute 8 and 10) | Percentage of patient whose average FiO2 level below 40% |
| Intensive care unit transfert criteria | Mean FiO2in the two last minute of each study period (between minute 8 and 10) | Percentage of patients whose average FiO2 level over 60% |
| Intubation criteria | Mean FiO2in the two last minute of each study period (between minute 8 and 10) | Percentage of patients whose average FiO2 level over 80% |
| Mean difference on oxymeter | assessed up to 10 minutes - at the same of the arterial blood gases punction | Mean (±SD) of the gaps between the different oximeters tested |
Countries
Canada
Contacts
CONTACTFrancois Lellouche Principal Investigator
Outcome results
None listed