High Flow Nasal Therapy Versus Noninvasive Ventilation in COPD Exacerbation

Launched by AZIENDA OSPEDALIERA UNIVERSITARIA POLICLINICO PAOLO GIACCONE PALERMO · Dec 7, 2017

Keywords

ClinConnect Summary

The interventions will be delivered in Emergency Departments or Intensive Care Units.

The intervention under investigation will be High flow nasal therapy. Investigators will deliver HFNT to enrolled patients using any available device able to produce it. The flow will be initially set at 60 liters per minute and temperature at 37° C. The target will be an oxygen saturation (SpO2) of 88-92%. In case of patient not tolerating these settings, flow and temperature will be titrated to the maximum tolerated level. The intervention will last until one of the following conditions: 1) physician in...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Presence of chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure;
• • 7.25 \< pH \< 7.35;
• • Arterial Partial pressure of carbon dioxide (PaCO2) equal or greater than 55 mmHg;
• • Age \> 18 years/old
• Exclusion Criteria:
• • Invasive mechanical ventilation in the last 60 days
• • Use of any form of noninvasive ventilation or high flow oxygen through nasal cannula (HFNT) prior to study enrollment after the onset of acute hypercapnic respiratory failure (AHRF);
• • Noninvasive home care ventilation;
• • Unstable clinical condition (need for vasopressors for \>24 h, acute coronary syndrome or life-threatening arrhythmias);
• • Refusal of treatment;
• • Agitation (RASS \>= +2) or non-cooperation (Kelly Matthay \>=5);
• • Failure of more than two organs;
• • Cardiac arrest;
• • Respiratory arrest requiring tracheal intubation;
• • Recent trauma or burns of the neck and face;
• • Pregnancy;
• • Refusal of consent;
• • Inclusion in other research protocols.