Predictors of High-Flow Nasal Cannula Failure (HFNC) in Patients With Acute Hypoxemic Respiratory Failure (AHRF) Using Diaphragm Ultrasound Parameters
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- High flow nasal cannula (HFNC) therapeutic failure
研究概览
简要总结
Ultrasound of the diaphragm is an easily reproducible bedside tool that provides a non-invasive measurement of inspiratory muscle function and respiratory efficiency. The diaphragmatic thickness correlates with the strength and muscle shortening and is reflective of its contribution to the respiratory workload. Diaphragm thickening fraction (DTF) has been shown to be predictive of extubation failure in ventilated patients. However, whether measurements of DTF are predictive of high flow nasal cannula (HFNC) outcomes in patients with acute hypoxemic respiratory failure (AHRF) remains unknown. The objective of this study is to identify predictors of HFNC failure by diaphragm ultrasound and to compare its performance with the well-established ROX index.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 100 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≧ 18; AND
- •Acute hypoxemic respiratory failure (AHRF), defined by respiratory rate of greater than 25 breaths per minute and a ratio of the PaO2 to the fraction of inspired oxygen (PaO2 / FiO2) of less than 300, and use of accessory muscles of respiration or paradoxical abdominal motion; AND
- •Required ventilatory support with high-flow nasal cannula (HFNC)
排除标准
- •Patients suffering from hypercapnic respiratory failure; OR
- •AHRF secondary to conditions that are indicated for non-invasive ventilation (NIV) (e.g. acute exacerbation of COPD, cardiogenic pulmonary edema); OR
- •Use of NIV or invasive mechanical ventilation (IMV) prior to HFNC initiation; OR
- •Patients with imminent need for endotracheal intubation and invasive mechanical ventilation (IMV); OR
- •Patients with known or suspected diaphragm paralysis; OR
- •Pregnancy; OR
- •Patients with abdominal compartment syndrome; OR
- •Use of HFNC for more than 12 hours prior to ICU admission; OR
- •Patients with suboptimal diaphragm ultrasound image quality for data processing; OR
结局指标
主要结局
High flow nasal cannula (HFNC) therapeutic failure
时间窗: From the start of recruitment into study (i.e. start of HFNC use), till the date of study endpoint (i.e., step up to non-invasive ventilation, intubation, death on HFNC, or weaned off HFNC, whichever came first), assessed up to 4 weeks.
Predictive value of diaphragm ultrasound in detecting high flow nasal cannula (HFNC)therapeutic failure in patients with acute hypoxemic respiratory failure (AHRF)
次要结局
未报告次要终点
研究者
Wincy Wing-Sze Ng
Associate Consultant, Adult Intensive Care Unit
Queen Mary Hospital, Hong Kong