Evaluation of Clinical Effectiveness of ECCO2R for the Treatment of Patients With Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- COPD Exacerbation
- Sponsor
- China-Japan Friendship Hospital
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- incidence of avoid endotracheal intubation
- Last Updated
- 6 years ago
Overview
Brief Summary
The conventional treatment for Severe acute exacerbation of Chronic obstructive pulmonary disease including noninvasive respiratory support, invasive respiratory support, etc, but there are many kinds of limitations and complications. Extracorporeal Carbon Dioxide Removal is a life support technology, which can effectively remove CO2. Recently some clinical studies have showed that ECCO2R can effectively improve the AECOPD patient's respiratory failure, avoid intubation and removal of endotracheal intubation. We performed a study to evaluate the clinical effectiveness of ECCO2R in the treatment of AECOPD patients.
Detailed Description
With the development of technology, ECCO2R is not difficult to implement in intensive care unit. Many recently clinical studies have showed that ECCO2R can effectively remove CO2, reduce patient breathing work, improve the patient respiratory failure, and avoid endotracheal intubation. But there are also treated failure and high incidence of complications such as bleeding in the AECOPD patients with ECCO2R treatment, and the treatment related to airway management are less mentioned. Therefore, we set a more strict inclusion criteria in AECOPD patients and evaluate the clinical effectiveness and associated risk of ECCO2R in the treatment of AECOPD.
Investigators
Qingyuan Zhan
head of Pulmonary and Critical care medicine ward 4
China-Japan Friendship Hospital
Eligibility Criteria
Inclusion Criteria
- •NPPV treatment failure:
- •deterioration or no improvement after treatment with NPPV, pH \< 7.25, PaCO2 \> 70mmHg
- •Obvious respiratory distress, RR \> 30 times/min
- •Breathing extreme fatigue
Exclusion Criteria
- •Older than 75 years
- •endotracheal intubation or tracheostomy
- •obviously a lot of pus yellow phlegm, expectorate difficult
- •Chest CT: obviously a wide range of consolidation
- •BMI \< 20 kg/m2,
- •Dysfunction of other organ of extrapulmonary
- •serious hemodynamic instability
- •severe hypoxemia, PaO2 / FiO2 \< 100mmHg
- •home noninvasive positive pressure ventilation for a long time
- •lung fungal infection
Outcomes
Primary Outcomes
incidence of avoid endotracheal intubation
Time Frame: 30days
avoid endotracheal intubation and Invasive mechanical ventilation