Highflow nasal cannula versus noninvasive ventilation in the prevention of escalation to invasive mechanical ventilation in patients with acute hypoxemic respiratory failure. A Randomised Comparative Interventional Study at SMS Medical College
Overview
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Department of Anaesthesiology SMS Medical College
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- To Assess Need for Invasive Mechanical Ventilation In Patients of Acute Hypoxemic Respiratory Failure.
Overview
Brief Summary
Patients with AHRF will be admitted to ICU.
Sample of patients satisfying the inclusion criteria will be selected for study and patients will be randomized into two groups by computer random number table method.
Patients will be assigned to NIV or HFNC.
Patient assigned NIV will be connected to ventilator for conventional NIV with full mask with following ventilator settings with PEEP 2 to 10 cm of water initially later PEEP or FiO2 or both will be set to keep SaO2≥92%. Ps level will be set to achieve expiratory tidal volume of 7 to 10 ml/kg.
Patient of other group will be connected to HFNC and heated humidified oxygen 31-37 C will be continuously supplied through binasal large bore prongs. Initial setting of oxygen flow rate will be 50L/min and FiO21.0, later setting of Fio2will be adjusted to attain SaO2≥92%
Following parameter will be recorded in both groups
- Total number of patients in percentage will be required need of intubation due to following reasons
pH < 7.20
paO2 <45mmHg
paCO2 >60mmHg
Cardiopulmonary arrest
-
To Measure Vital parameters (SBP, DBP, MAP, HR, RR, SPO2) at inclusion and at 12, 24, 36, 48, 60, 72 hours.
-
To Assess Respiratory Acidosis by recording ABG at 1, 6, 24, 48 hours of study treatment.
-
To Assess no. of days on HFNC/NIV before escalation to intubation.
-
To Assess no. of duration of ICU stay.
-
To Measure Hospital Mortality.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Masking
- Double
Eligibility Criteria
- Ages
- 18.00 Year(s) to 60.00 Year(s) (—)
- Sex
- All
Inclusion Criteria
- •Patient willing to give consent Patients having AHRF defined by PaO2/FiO2 less than or equal to 300mmhg Patient not responding to conventional oxygen therapy Patient requiring ventilator support due to increased respiratory rate.
Exclusion Criteria
- •Absolute indication for intubation Contraindication to NIV PaCO2 more than 45mmhg Chronic respiratory failure.
Outcomes
Primary Outcomes
To Assess Need for Invasive Mechanical Ventilation In Patients of Acute Hypoxemic Respiratory Failure.
Time Frame: until Invasive Mechanical Ventilation
Secondary Outcomes
- 1.To measure vital parameters (SBP, DBP, MAP, HR, RR, SPO2)(2.To assess respiratory acidosis by recording ABG.)
Investigators
Dr Nihar Sharma
Sms medical college