Asthma Exacerbation, COPD Exacerbation, Hypercapnia
Conditions
Brief summary
The aim of this observational before/after study is to determine how to optimally administer oxygen to patients experiencing an asthma or COPD exacerbation in emergency medical services. The aim will be to determine which method will achieve the target oxygen saturation objectives: \> 95% in asthma exacerbations and between 88% and 92% (or \> 92% in ambient air or with FiO2 21%) in COPD exacerbations. The study will compare a group "before" receiving standard care with a nebulizer mask to a group "after" using a combination of a vibrating membrane nebulizer and high-flow nasal oxygen.
Detailed description
The "after" group will systematically receive both devices: vibrating membrane nebulizer and high-flow nasal oxygen. In both groups, the choice of nebulized therapies will be left to the clinician's discretion.
Interventions
DEVICEVibrating membrane nebulizer and high-intensity nasal oxygen
Vibrating membrane nebulizer and high-intensity nasal oxygen
DEVICEnebulizer mask and oxygen therapy of 6 to 9 liters per minute
nebulizer mask and oxygen therapy of 6 to 9 liters per minute
Sponsors
Centre Hospitalier Sud Francilien
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ≥ 18 years of age * Exacerbation of asthma or COPD requiring nebulization * Free and informed consent
Exclusion criteria
* Clinical signs of hypercapnia * Non French speaker * Contraindications to high-flow nasal oxygen: haemodynamic instability, Glasgow \< 12, cardiorespiratory arrest, lack of airway protection, cardiogenic pulmonary oedema * Indication for orotracheal intubation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Achievement of saturation targets | at 15 minutes | * Asthma: SpO₂ at 15 min \> 95% * COPD: SpO₂ at 15 min 88-92% or SpO₂ \> 92% in ambient air or with FiO₂ 21% |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| FiO₂ | at the end of care | Successful implementation of the vibrating membrane nebulizer and high-flow nasal oxygen devices |
| flow rate | at the end of care | Successful implementation of the vibrating membrane nebulizer and high-flow nasal oxygen devices |
| Likert scale | up to 30 minutes | Likert scale on the ease of use of the device |
| Causes of failure | up to 30 minutes | For the "after" group |
Countries
France
Outcome results
None listed