Evaluation of Clinical Effectiveness of ECCO2R for the Treatment of Patients With Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease
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
- incidence of avoid endotracheal intubation
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •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
- •contraindication of anticoagulation
- •Platelet < 80000 per cubic millimeter
- •Serum creatinine > 200 umol/L
- •cardiac arrest
- •Hospice care
- •Refused to take part in the study
结局指标
主要结局
incidence of avoid endotracheal intubation
时间窗: 30days
avoid endotracheal intubation and Invasive mechanical ventilation
次要结局
未报告次要终点
研究者
Qingyuan Zhan
head of Pulmonary and Critical care medicine ward 4
China-Japan Friendship Hospital