High Flow Nasal Cannula Versus Non-Invasive Ventilation in Exacerbations of Chronic Obstructive Pulmonary Disease

Launched by UNITY HEALTH TORONTO · Jan 24, 2017

Keywords

ClinConnect Summary

This clinical trial is studying two different methods of providing breathing support to patients with Chronic Obstructive Pulmonary Disease (COPD) who are experiencing severe flare-ups, known as exacerbations. The trial compares High Flow Nasal Cannula (HFNC), which delivers heated and humidified air and oxygen through a simple nasal tube, to Non-Invasive Ventilation (NIV), which uses a mask to assist breathing. The goal is to see if HFNC is just as effective as NIV while being more comfortable for patients, as many find the mask difficult to tolerate.

To participate in the trial, individuals must be over 40 years old, speak English, and be experiencing a COPD exacerbation with specific breathing difficulties. Patients with severe acidosis, decreased consciousness, or other serious health issues will not be eligible. If you qualify and choose to participate, you can expect to receive one of the two breathing support methods and be monitored by healthcare professionals to assess how well it helps your breathing. This research could help improve care for COPD patients in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. COPD exacerbation and acute hypercapnic respiratory failure with acute respiratory failure defined by
• • Respiratory acidosis (pH ≤7.35 and PaCO2 ≥45 mmHg);
• • Respiratory rate≥20 breaths/min;
• • Activation of accessory respiratory muscles;
• • 2. Undergone at NIV or HFNC since their admission
• • 3. English speaking
• • 4. Adult patient with age \> 40 year old.
• Exclusion Criteria:
• • 1. Severe respiratory acidosis defined by pH\<7.25
• • 2. Decreased level of consciousness (Glasgow Coma Score Scale \< 11)
• • 3. Urgent intubation required
• • 4. Pneumothorax with pleural drainage and persistent air leak
• • 5. Hemodynamic instability requiring vasopressors
• • 6. Uncooperative
• • 7. Patients with skin or chest wall or abdominal trauma (potentially worsened by placement of a surface sensor)
• • 8. Clinical judgement of the attending physician
• • 9. Body mass index \> 40 kg/m2