Early-initiated High Flow Nasal Oxygen Therapy in Pneumonia Patients Presenting With Acute Hypoxemic Respiratory Failure
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pneumonia
- Sponsor
- Assiut University
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- The rate of intubation among participant
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
High-flow nasal oxygen (HFNO) therapy is an upcoming and beneficial modality for patients with acute hypoxemic respiratory failure (AHRF).
To evaluate whether early use of HFNO in pneumonia patients with (AHRF) can reduce the need for invasive ventilation.
Detailed Description
* Pneumonia adults patients (age\>18 years) with AHRF were eligible for this study after conventional oxygen therapy failure. * The criteria for diagnosing AHRF were defined as the presence of a respiratory rate (RR) more than 25 breaths/min with SpO2 less than 92%, and/or the arterial oxygen partial pressure (PaO2) to FiO2 ratio less than 300 mmHg while breathing oxygen delivered by a conventional venturi device at a fraction of inspiration oxygen of 0.5 (as per maximum for Venturi mask) administered for at least 60 minutes. Eligible patients were randomized to receive either HFNO or NIV respiratory support throughout the hospitalization period. Randomization was stratified by a laboratory scientist not involved in the study using the technique of shuffled sealed envelopes.
Investigators
Doaa Magdy Eid
associate proffessour
Assiut University
Eligibility Criteria
Inclusion Criteria
- •Pneumonia adults patients (age\>18 years) with AHRF were eligible for this study after conventional oxygen therapy failure.
- •The criteria for diagnosing AHRF were defined as the presence of a respiratory rate (RR) more than 25 breaths/min with SpO2 less than 92%, and/or the arterial oxygen partial pressure (PaO2) to FiO2 ratio less than 300 mmHg while breathing oxygen delivered by a conventional venturi device at a fraction of inspiration oxygen of 0.5 (as per maximum for Venturi mask) administered for at least 60 minutes.
- •Exclusion criteria:
- •Patients requiring emergency intubation,
- •Recent esophageal, facial, or cranial trauma or surgery,
- •Severely decreased consciousness (Glasgow coma scale \[GCS\] of 11 or less),
- •Severe hemodynamic instability (patient on inotropic or vasopressor support), ° Severe ventricular arrhythmia or myocardial ischemia,
- •Tracheotomy or other upper airway disorders,
- •Active upper gastrointestinal bleeding, and
- •Inability to clear respiratory secretions .
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
The rate of intubation among participant
Time Frame: within 72 hours after admission
The criteria for immediate intubation were: cardiac arrest or obvious hemodynamic instability, refractory hypoxemia (PaO2 \< 50mmHg with sufficient oxygen therapy), significant hypercapnia with pH ≤ 7.20, loss of consciousness or gasping for air, psychomotor agitation, or severe dyspnea (respiratory frequency \> 40/min)
Secondary Outcomes
- Improvement of respiratory exchanges compared to baseline(hospital admission until the achievement of clinical stability (72 hours))
- Dyspnea(hospital admission until the achievement of clinical stability (72 hours))
- Mortality rate(at 28 days)