Comparison of HFNC With NIV in Weaning COPD
- Conditions
- Chronic Obstructive Pulmonary Disease With (Acute) Exacerbation
- Interventions
- Device: High flow nasal cannulaDevice: Noninvasive ventilation
- Registration Number
- NCT03458364
- Lead Sponsor
- Jie Li
- Brief Summary
High flow nasal cannula (HFNC) has been shown to improve oxygenation and facilitate weaning in hypoxemia patients. Some clinical studies show the benefits of using HFNC in COPD patients, including reducing dead space and work of breathing. However, no clinical study has been to investigate the value of HFNC in weaning COPD patients from invasive ventilation. Thus, we proposed a randomized controlled trial to compare the use of HFNC and noninvasive ventilation (NIV) in weaning COPD.
- Detailed Description
High flow nasal cannula (HFNC) provides high concentration oxygen in a high flow, which exceeds patient's inspiratory flow demand, to improve oxygenation. In a recent meta-analysis of seven trials with 1771 patients, HFNC was shown to improve oxygenation and avoid intubation in patients with severe hypoxemia. The high velocity of the gas can rinse the dead space of the upper airway and reduce CO2 rebreathing, reduce COPD patients' work of breathing and improve the dynamic compliance of respiratory system.
Thus, we proposed a randomized controlled trial to investigate the value of high flow nasal cannula in weaning AECOPD patients from invasive ventilation, with comparison of noninvasive ventilation.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 42
- Intubated patients with Chronic obstructive pulmonary disease exacerbation
- Meeting extubation criteria (Pulmonary infection control window)
- Age > 21years and < 90 years
- Tracheotomy
- Combined with severe dysfunction of other organs, including heart, brain, liver, and renal failure;
- Hemodynamic instability
- Contraindication to NIV: cannot use mask, such as facial injury, burns or deformities; cannot cooperate with NIV such as delirium; copious secretions with weak cough ability; gastric over distention, and vomiting;
- Contraindication to HFNC: rhinitis, nasal congestion, deformities or blockage.
- Weak cough ability with copious secretions
- Refuse to participate in the study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description High flow nasal cannula High flow nasal cannula High flow nasal cannula (HFNC) is a type of oxygen device, which provides high concentration oxygen in a high flow, which exceeds patient's inspiratory flow demand, to improve oxygenation. Noninvasive ventilation Noninvasive ventilation Non-invasive ventilation (NIV) refers to the provision of ventilatory support through the patient's upper airway using a mask. This technique is distinguished from those which bypass the upper airway with a tracheal tube, laryngeal mask, or tracheostomy and are therefore considered invasive.
- Primary Outcome Measures
Name Time Method pH change from the baseline pH within 48 hours pH
PaO2/FiO2 change from the baseline PaO2/FiO2 within 48 hours partial pressure of oxygen in arterial blood/ fraction of inspired oxygen in mmHg
RR change from the baseline RR within 48 hours respiratory rate in breaths per minute
HR change from the baseline HR within 48 hours Heart Rate in beats per minute
PaCO2 change from the baseline PaCO2 within 48 hours PaCO2 in mmHg
MAP change from the baseline MAP within 48 hours mean arterial pressure in mmHg
- Secondary Outcome Measures
Name Time Method incidence of barotrauma 28 days the patients' comfort score 48 hours comfort score of using high flow nasal cannula or noninvasive ventilator, ranging from 1 to 10. 1 means very comfortable, 10 means very uncomfortable.
Mortality 28 days incidence of nasal trauma 28 days duration of respiratory support 28 days hours of ventilator use
Length of ICU stay 28 days Days of stay in ICU
Trial Locations
- Locations (1)
Binzhou Medical University Hospital
🇨🇳Yantai, Shandong, China