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Comparison of Two Oxygen Setting During Non-invasive Mechanical Ventilation of Chronic Obstructive Pulmonary Disease

Not Applicable
Terminated
Conditions
Chronic Obstructive Pulmonary Disease With Acute Exacerbation, Unspecified
Interventions
Device: Non-invasive mechanical ventilation - Controlled hypoxemia
Device: Non-invasive mechanical ventilation - Normoxia
Registration Number
NCT02563314
Lead Sponsor
Centre Hospitalier Universitaire de Saint Etienne
Brief Summary

Hypoxaemic patients with exacerbations of chronic obstructive pulmonary disease (COPD) are at some risk of carbon dioxide (CO2) retention during oxygen therapy. Main mechanism of CO2 retention is believed to be reversal of preexisting regional hypoxic pulmonary vasoconstriction, resulting in a greater dead space. Risk of CO2 retention during mechanical ventilation remains controversial. Thus recent study suggested limited risk of CO2 retention with controlled oxygen supplementation during mechanical ventilation. Conversely, controlled oxygen supplementation might decrease dyspnea and respiratory workload, increase comfort and improve both urinary output and renal function.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
1
Inclusion Criteria
  • Age > 18 years
  • Acute hypercapnic COPD exacerbation
  • Respiratory acidosis
  • Intensive care unit admission
  • Non-Invasive mechanical ventilation for less than 24 hours
  • Patients or proxy consent
  • Patients affiliated with the General Social Security Health System
Exclusion Criteria
  • Pregnancy
  • Sickle cells disease
  • Acute coronary syndrome
  • Restrictive respiratory disease
  • Stage 4 or 5 chronic kidney disease
  • COPD exacerbation following a first episode of conventional mechanical ventilation
  • Contraindications to non-invasive ventilation

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
controlNon-invasive mechanical ventilation - Controlled hypoxemia-
interventionNon-invasive mechanical ventilation - Normoxia-
Primary Outcome Measures
NameTimeMethod
urinary output (ml)24 hours

First 24 hours of non-invasive mechanical ventilation

Secondary Outcome Measures
NameTimeMethod
Serum creatinine24 hours, 48 hours, 72hours

First 24 hours of non-invasive mechanical ventilation

Renal resistive index24 hours, 48 hours, 72hours

First 24 hours of non-invasive mechanical ventilation

Changes in CO2 levels24 hours, 48 hours, 72hours

First 24 hours of non-invasive mechanical ventilation

Fluid balance24 hours, 48 hours, 72hours

First 24 hours of non-invasive mechanical ventilation

SOFA (Sequential Organ Failure Assessment) score24 hours, 48 hours, 72hours

First 24 hours of non-invasive mechanical ventilation

respiratory workload during non-invasive mechanical ventilation (occlusion pressure (cm H2O) to 100 ms after the onset of inspiration)24 hours, 48 hours, 72 hours

First 24 hours of non-invasive mechanical ventilation

Semiquantitative assessment of comfort (visual likert scale)24 hours, 48 hours, 72hours

First 24 hours of non-invasive mechanical ventilation

Pulmonary arterial pressure24 hours, 48 hours, 72hours

First 24 hours of non-invasive mechanical ventilation

Mortalityup to day 28

First 24 hours of non-invasive mechanical ventilation

Semiquantitative assessment of dyspnea (visual likert scale)24 hours, 48 hours, 72hours

First 24 hours of non-invasive mechanical ventilation

Number of patients requiring mechanical ventilationup to day 28

Evaluation until 28 days with an evaluation at intensive care unit discharge, and at hospital discharge

days alive without mechanical ventilationup to day 28

Evaluation up to 28 days with an evaluation at intensive care unit discharge, and at hospital discharge

Trial Locations

Locations (4)

CHU de la Pitié-Salpêtrière

🇫🇷

Paris, France

CHU de CLERMONT-FERRAND

🇫🇷

Clermont-ferrand, France

CHU de SAINT-ETIENNE

🇫🇷

Saint-etienne, France

CHu de GRENOBLE

🇫🇷

Grenoble, France

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