Status:
RECRUITING
Asymmetrical Versus Conventional High-flow Nasal Cannula in Acute Respiratory Failure
Lead Sponsor:
Siriraj Hospital
Conditions:
Acute Hypoxemic Respiratory Failure
Acute Hypercapnic Respiratory Failure
Eligibility:
All Genders
18-90 years
Phase:
NA
Brief Summary
The goal of this randomized crossover physiological study is to evaluate the physiologic effects of asymmetrical nasal cannula and conventional nasal cannula in patients with acute respiratory failure...
Detailed Description
High-flow nasal cannula (HFNC) is increasingly used in patients with acute respiratory failure. The physiologic benefits of HFNC can be explained via several mechanisms. These mechanisms lead to impro...
Eligibility Criteria
Inclusion
- Patients with acute hypoxemia respiratory failure
- Age \> 18 years old
- Acute respiratory failure within 7 days of hospital admission?
- Hypoxemia defined by arterial partial pressure of oxygen (PaO2)/FiO2 \< 300 mmHg or SpO2/FiO2 \< 315
- Already supported with HFNC device
Exclusion
- Respiratory acidosis: pH \< 7.30 and PaCO2 \> 45 mmHg
- Hemodynamic instability requiring vasopressor initiation
- Diminished level of consciousness or uncooperative
- Active hemoptysis or pneumothorax requiring a chest tube
- Chronic severe neuromuscular disease
- Pregnancy
- Patients with acute hypercapnic COPD Inclusion criteria
- Age \> 40 years old
- Diagnosed COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline (postbronchodilator forced expiratory volume at 1 second (FEV1)/forced vital capacity (FVC) \< 70%)
- Exacerbation requiring hospitalization; at least 2 of the following criteria
- Respiratory rate \> 24/min
- Use of respiratory accessory muscles or paradoxical motion of the abdomen
- Acute respiratory acidosis with arterial or venous pH \< 7.35 and/or PaCO2 \> 45 mmHg
- Exclusion criteria
- pH \< 7.25
- Hemodynamic instability requiring vasopressor initiation
- Persistent hypoxemia despite supplemental oxygen therapy
- Diminished level of consciousness or uncooperative
- Active hemoptysis or pneumothorax requiring a chest tube
- Associated severe chronic neuromuscular disease
- Pregnancy
Key Trial Info
Start Date :
January 20 2024
Trial Type :
INTERVENTIONAL
Allocation :
ESTIMATED
End Date :
May 15 2025
Estimated Enrollment :
40 Patients enrolled
Trial Details
Trial ID
NCT06204276
Start Date
January 20 2024
End Date
May 15 2025
Last Update
January 25 2024
Active Locations (1)
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1
Faculty of Medicine Siriraj Hospital
Bangkok Noi, Bangkok, Thailand, 10700