Evaluation of Efficiency of High Flow Nasal Cannula Versus Noninvasive Ventilation in Patients With Acute Hypercapnic Respiratory Failure
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- failure of treatment modality
研究概览
简要总结
Background: In acute hypoxic respiratory failure, high-flow nasal cannula (HFNC) oxygen treatment is gaining popularity. However, there is just a small body of research to back up the use of HFNC in acute respiratory failure (ARF) with hypercapnia.
Aim of study: To evaluate the effectiveness of high-flow nasal cannula (HFNC) in reducing the rate of endotracheal intubation and PCO2 level in adult patients with Acute moderate type II respiratory failure in comparison to noninvasive positive pressure ventilation (NIPPV).
Methods : A randomized control trial that was conducted on patients with acute moderate hypercapnic respiratory failure ARF (arterial blood gases pH 7.25-7.35, PaCO2>45 mmHg) who were admitted to respiratory and medical critical care units from September 2020 through February 2022 and received HFNC or NIV .The endpoint was treatment failure, which was indicated by either invasive ventilation or mortality .
详细描述
Adult patients of both sex who were admitted to ICU with acute moderate hypercapnic respiratory failure.
Included patients were divided into two groups:
- Group A: 50 patients with acute moderate hypercapnic respiratory failure who were treated with HFNC as ventilatory support .
- Group B: 50 patients with acute moderate hypercapnic respiratory failure who were treated with NIV as ventilatory support .
Device used:
- For group A (HFNC) : we used either Airvo 2 Manufacturer: Fisher &Paykel Co. , Precision flow Hi - VNI ™ (Vapotherm ) or built in HFNC mode in (e Volution ventilator ) .
- For group B (NIV) :we used Puritan Bennett™ 840 Ventilator and the used interface was oro nasal mask of fitting size to each patient .
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Acute moderate Hypercapnic respiratory failure patients defined by PH: >7.25 and <7.35 and PCO2 >45mmHg who were admitted to icu and received HFNC or NIV
排除标准
- •Patients aged <18 years
- •Patients with altered consciousness defined by a Glasgow coma score of >12 points.
- •Hemodynamic instability defined by systolic arterial blood pressure 90 mmHg, mean arterial blood pressure 65 mm Hg, on vasopressor, confusion , chest pain or loss of consciousness )
- •Patients who need immediate endotracheal intubation.
- •Contraindication to NIV (oral and facial trauma, excessive phlegm with poor expectoration ability, vomiting and Epistaxis)
- •Post cardiac arrest patients.
结局指标
主要结局
failure of treatment modality
时间窗: 1 hour
failure of improvement of PH
次要结局
- mortality(28 day)
- ICU stay(28 day)
研究者
Gehad Ahmed Ali
principle investigator
Beni-Suef University