Lung MORphological Modifications Evaluated by Electrical Impedance Tomography During Preoxygenation for the Intubation of Hypoxemic Patients: Comparison of Standard Oxygenation, High Flow Nasal Oxygen Therapy, and NonInvasive Ventilation (MORPHEIT Study, an Ancillary Study of PREONIV Trial)
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- evolution of lung aeration evaluated by electrical impedance tomography during the preoxygenation for intubation of hypoxemic patients and the arterial blood oxygenation
研究概览
简要总结
Prospective, randomized clinical multicentric study, in ICU, during preoxygenation for the intubation of hypoxemic patients.
Electrical impedance tomographic evaluation of lung morphology variations according to the preoxygenation technique : Comparison of Standard Oxygenation, High Flow Nasal Oxygen Therapy, and NonInvasive Ventilation
详细描述
Preoxygenation before endotracheal intubation in the ICU is a prerequisite to limit complications, ranging from desaturation, severe hypoxemia and bradycardia with potential cardiac arrest and death. International recommendations suggest the use of non-invasive ventilation (NIV) technique whenever possible. High flow nasal cannula (HFNC) has recently gained growing interest in the ICU as a treatment of acute respiratory failure, to improve extubation success and as a preoxygenation device before endotracheal intubation. Conflicting results have been published.
The PREONIV study was designed to compare NIV, HFNC and conventional preoxygenation with valve bag mask for the preoxygenation before endotracheal intubation.
Investigator propose to add a lung morphology analysis during preoxygenation. Electrical impedance tomography (EIT) is a non invasive tool which analyse lung aeration variations via the evolution of local thoracic impedances with electrical loop circulating around a thoracic belt with electrodes.
The hypothesis is that the technique of preoxygenation might correlate with oxygen desaturation and potential intubation related complications (PREONIV study). Moreover lung morphology modifications evaluated by EIT might be associated with the preoxygenation technique (MORPHEIT study).
Investigator wish to asses lung morphological modifications evaluated by EIT during preoxygenation in a prospective non blinded randomized fashion.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
盲法说明
open
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •• adults patients
- •requiring intubation and hypoxemia (defined by PaO2/FiO2 below 200)
- •patient covered by french health care system
- •patient included in Hopital Estaing, Clermont-Ferrand
排除标准
- •• patient refusal
- •intubation for other causes (excluding hypoxemia)
- •impossibility to measure pulse oxymetry value
- •contraindication for NIV : vomiting
- •NIV intolerance
- •cardiac arrest during intubation
研究组 & 干预措施
standard oxygenation
Electrical impedance tomographic evaluation of lung morphology variations according to the preoxygenation technique : Comparison of Standard Oxygenation, High Flow Nasal Oxygen Therapy, and NonInvasive Ventilation
干预措施: Standard oxygenation (Procedure)
High flow nasal oxygen therapy
Electrical impedance tomographic evaluation of lung morphology variations according to the preoxygenation technique : Comparison of Standard Oxygenation, High Flow Nasal Oxygen Therapy, and NonInvasive Ventilation
干预措施: High flow nasal oxygenation (Procedure)
NonInvasive Ventilation
Electrical impedance tomographic evaluation of lung morphology variations according to the preoxygenation technique : Comparison of Standard Oxygenation, High Flow Nasal Oxygen Therapy, and NonInvasive Ventilation
干预措施: noninvasive ventilation (Procedure)
结局指标
主要结局
evolution of lung aeration evaluated by electrical impedance tomography during the preoxygenation for intubation of hypoxemic patients and the arterial blood oxygenation
时间窗: at day 1
次要结局
- Lung inhomogeneity index(at day 1 (during and after preoxygenation and at 5 minutes and at 30 minutes after intubation))
- Partial pressure of arterial oxygen (PaO2)(at day 1)
- Regurgitation rate(at day 1)
- electrical impedance tomography related indexes(at day 1 (before, during and after preoxygenation and at 5 minutes and at 30 minutes after intubation))
- End expiratory lung impedance(at day 1 (during and after preoxygenation and at 5 minutes and at 30 minutes after intubation))
- Center of Ventilation(at day 1 (during and after preoxygenation and at 5 minutes and at 30 minutes after intubation))
- Tidal Volume(at day 1 (during and after preoxygenation and at 5 minutes and at 30 minutes after intubation))
- pulse oxymetry value(at day 1 (at 5 minutes and at 30 minutes after intubation))
- oxyhemoglobin desaturation below 80 %(at day 1)