Respiratory Stabilization in Chronic Acidosis Before Bronchofiberoscopy & Non-Invasive Ventilation Effectivenes

Launched by MEDICAL UNIVERSITY OF SILESIA · May 5, 2025

Keywords

ClinConnect Summary

This clinical trial is investigating the best ways to support patients with chronic respiratory acidosis during a procedure called bronchofiberoscopy (FOB), which helps doctors diagnose or treat lung conditions. The study will look at patients with specific breathing issues and compare three types of respiratory support: passive oxygen therapy, non-invasive ventilation (NIV), and high flow nasal cannula (HFNC). The goal is to find out which method helps patients breathe better and experience fewer complications during and after the procedure.

To participate in this trial, you need to be at least 18 years old and have a medical reason for needing a bronchofiberoscopy, such as suspected lung cancer or other lung conditions. You should also have certain blood gas test results that indicate a respiratory acidosis condition. Participants will undergo blood tests before and after the procedure to monitor their breathing and overall health. Throughout the trial, the medical team will closely track your vital signs to ensure your safety and comfort. This study aims to improve the care and support available for patients with breathing difficulties, leading to quicker diagnoses and more comfortable procedures.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• 1. Patient ≥ 18 years of age with indications for diagnostic bronchoscopy:
• • ◦ Diagnostic test: suspected lung cancer, suspected sarcoidosis, mediastinal lymphadenopathy,
• • 2. Patient who signed a written informed consent to participate in the study,
• • 3. pCO2 \> 45 mmHg and/or HCO3- \> 27 mmol/l but pH ≥ 7.35 in a blood gas test performed immediately before qualification for bronchoscopy.
• Exclusion Criteria:
• • 1. Lack of written informed consent of the subject to participate in the research project,
• • 2. Coronary artery disease CCS III/IV,
• • 3. Hemodynamic failure, use of pressor amines, myocardial infarction in the last 2 weeks without PCI treatment, unstable angina pectoris, severe arrhythmias - especially ventricular,
• • 4. Pneumothorax not secured with drainage,
• • 5. Platelet count \<20,000/µl, if platelets are not transfused immediately before/during the procedure,
• • 6. INR \> 1.5xULN or APTT \>36 s.1.5xULN, in the case of diagnostic FOB \[16\],
• • 7. Anemia: hemoglobin (Hb) level \<6 g/dl or 6-10 g/dl if the physician prescribes a blood transfu-sion,
• • 8. Patients who were intubated before randomization.