High Flow Nasal Cannula in the Emergency Department

Completed

• Conditions: Acute Respiratory Failure

• Registration Number: NCT03460119
• Lead Sponsor: Hospital Italiano de Buenos Aires

Brief Summary

The aim of this study was to describe the changes in respiratory rate, heart rate and dyspnea, before and after using HFNC in patients presenting to our emergency department with ARF.

Detailed Description

A retrospective cohort study was performed. To all adults presenting to the emergency department who used high flow nasal cannula to treat clinical signs of acute respiratory failure based on the presence of a breathing frequency ≥ 25 breath/min and increase work of breathing evidence by dyspnea, in-drawing, accessory-muscle use and/or diaphoresis despite conventional oxygen therapy ≥ 6 l/min. Demographic variables and clinical and gasometric parameters before and after two hours using HFNC were recorded.

Study Timeline

• Study Start: 2015-07-01
• Primary Completion: 2017-01-31
• Study Completion: 2017-01-31
• Status Verified: 2018-02
• Study First Submitted: 2018-02-20
• Study First Submitted QC: 2018-03-02
• Last Update Submitted: 2018-03-02
• Study First Posted: 2018-03-09
• Last Update Posted: 2018-03-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 43

Inclusion Criteria

• patients aged ≥ 18 years
• attended between July 1st, 2015 and January 31st , 2017 in the Emergency Department of the Hospital Italiano de Buenos Aires
• with clinical signs of acute respiratory failure

Exclusion Criteria

• Pulse oximetry > 90% breathing room air

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Heart Rate	2 hours	The closest value of Heart Rate before starting HFNC, and two hours later was collected from the electronic clinical history.
Dyspnea	2 hours	The closest value of Dyspnea (Modified Borg Dyspnea scale) before starting HFNC, and two hours later was collected from the electronic clinical history. The Modified Borg Dyspnea Scale is a rated numerical score used to measure dyspnea. This scale has a minimum value of 0 ( represent no dyspnea) and a maximum value of 10 (worse dyspnea).
Respiratory Rate	2 hours	The closest value of Respiratory Rate before starting HFNC, and two hours later was collected from the electronic clinical history.

Secondary Outcome Measures

Name	Time	Method
Delay of HFNC treatment	until 24hs	The hours between the admission to HFNC initiation were collected from the electronic clinical history.
Failure of HFNC treatment	28 days	When the patient need non-invasive or invasive ventilatory support or died. The type of ventilatory support post-failure were collected from the electronic clinical history.
Average time of use the HFNC	until 28 days	The total hours of use of HFNC were collected from the electronic clinical history.
Initial HFNC setting	2 hours	The gas flow rate and the fraction of inspired oxygen at the HFNC initiation of treatment were collected from the electronic clinical history.
Acute respiratory failure etiology	3 minutes	Presence of a breathing frequency ≥ 25 breath/min and increase work of breathing evidence by dyspnea, in-drawing, accessory-muscle use and/or diaphoresis despite conventional oxygen therapy ≥ 6 l/min.
Efficacy of HFNC treatment	28 days	When the patient did not need for escalation to other non-invasive or invasive ventilatory support.
Palliative Care	28 days	Consensus between patient and/or patient´s family and the physician about the care for the terminally ill patient, provided by an organized health service
Mortality rate at 28 day from ED admission	28 days	The number of patients who died after requiring HFNCO were collected from the electronic clinical history