HVNI vs NIPPV in Type 2 Respiratory Failure

Launched by NATIONAL UNIVERSITY HOSPITAL, SINGAPORE · Jul 3, 2025

Keywords

ClinConnect Summary

This clinical trial is studying two different ways to help patients who are having trouble breathing due to a condition called type 2 respiratory failure, where the body has too much carbon dioxide in the blood. The researchers want to find out if a newer treatment called high velocity nasal insufflation (HVNI), which delivers oxygen through small tubes in the nose, works just as well as the more commonly used method called non-invasive positive pressure ventilation (NIPPV), which helps patients breathe using a mask without needing a breathing tube. The main goal is to see if HVNI can lower the carbon dioxide levels in the blood as effectively as NIPPV within 30 minutes of treatment.

Adults aged 21 and older who come to the emergency department with this breathing problem and need NIPPV may be eligible to join the study. However, patients who have certain medical conditions, such as severe facial injuries, are unstable, or need emergency intubation (a breathing tube), or who choose not to participate, will not be included. If you take part, you will be randomly assigned to receive either HVNI or NIPPV, and the medical team will carefully monitor how your breathing and carbon dioxide levels respond. This study is not yet recruiting patients but aims to help doctors understand if HVNI can be a safe and effective alternative treatment in emergency settings.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • adult patients aged 21 years and above, who require NIPPV for T2RF due to any cause in the Emergency Medicine Department of the National University Hospital
• Exclusion Criteria:
• • patients with "do-not-resuscitate" orders that include NO non-invasive ventilation use \[patients with max NIV status will still be included\]
• • clinical suspicion or confirmed diagnosis of base of skull fractures or severe facial trauma that precludes NIPPV or nasal cannula placement
• • vulnerable patient populations (e.g., pregnant women, prisoners)
• • patients who refused consent
• • hemodynamic instability (e.g., hypotension requiring immediate resuscitation), cardiac or respiratory arrest
• • patients who require emergency intubation