asal High Flow Oxygen Versus Non Invasive Positive Pressure Ventilation in Emergency Department Patients With Cardiogenic Pulmonary Edema: A Randomized Non-inferiority Trial

Siriraj Research and Development Fund0 个研究点目标入组 240 人开始时间: 2021年4月13日最近更新: 2024年8月19日

适应症

试验速览

暂无简介。

•1.Adult patients (18 years of age and above) presenting with ACPE diagnosed by the attending ED physician by meeting all of the following criteria
•-History of acute dyspnea
•-Bilateral rales on physical examination
•-At least one of the following signs on the initial chest radiograph: pulmonary venous congestion, cardiomegaly, and interstitial edema
•2.Significant respiratory distress in need for non-invasive respiratory support measures by meeting all of the following
•-Respiratory rate (RR) > 24 breaths/min
•-Pulse oximetry (SpO2) < 92% when breathing at room air or arterial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) < 300 or SpO2/FiO2 < 240
•-Signs of respiratory distress, e.g., accessory muscle use

•1.Respiratory failure needing immediate endotracheal intubation, defined as RR > 35 breaths/min, SpO2 < 90% despite oxygen supplement at FiO2= 1.0, or abdominal dyssynchrony
•2.Patients with cardiac or respiratory arrest
•3.Patients with hemodynamic instability, defined as systolic blood pressure < 90 mmHg or mean arterial pressure < 65 mmHg with signs of poor tissue perfusion
•4.Patients with altered mental status, defined as a Glasgow Coma Scale (GCS) score < 13
•5.Agitated or non-cooperative patients
•6.Patients contraindicated to the use of NIPPV and HFNC, i.e. at risk for aspiration, known or suspected pneumothorax
•7.Patients with chronic kidney disease stage V or end-stage renal disease
•8.Patients with ST-segment elevation myocardial infarction
•9.Patients with do-not-intubate order
•10.Patients with long-term non-invasive or invasive respiratory support
•11.Patients with a tracheostomy tube
•12.Pregnant patients

发起方

Siriraj Research and Development Fund