Status:

NOT_YET_RECRUITING

Impact on Mortality of a Strategy Including Continuous Positive Airway Pressure Plus High Flow Nasal Cannula Oxygen Therapy Versus High Flow Nasal Cannula Oxygen Therapy Alone in Patients With de Novo Acute Hypoxemic Respiratory Failure: a Prospective, Randomized Controlled Trial.

Lead Sponsor:

Assistance Publique - Hôpitaux de Paris

Conditions:

De Novo Hypoxemic Acute Respiratory Failure (hARF)

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

De novo hypoxemic acute respiratory failure (hARF) is one of the main causes of intensive care unit (ICU) admission. In de novo hARF, intubation is associated with a dramatic increase in mortality rat...

Eligibility Criteria

Inclusion

  • Adults (≥ 18 years old)
  • Admitted in the ICU for ≤ 24 hours
  • De novo hARF defined by the three following criteria:
  • Respiratory rate \> 25 breaths/min or signs of respiratory distress such as labored breathing or paradoxical inspiration
  • PaO2/FiO2 ≤ 200 mmHg under HFNC with flow ≥ 45 L/min, actual FiO2 being considered.
  • Uni or bilateral pulmonary infiltrate on chest X-ray or CT scan
  • Informed consent from the patient or her/his next of kin or another substitute decision maker, or inclusion procedure in emergency if the patient is unable to consent

Exclusion

  • Refusal of study participation by the patient or the proxy
  • Anatomical factors precluding the use of a nasal cannula or CPAP
  • Long term oxygen
  • Home CPAP or NIV
  • Hypercapnia indicating NIV (PaCO2 \> 45 mmHg)
  • Isolated cardiogenic pulmonary oedema indicating NIV
  • Known pregnancy or breastfeeding
  • Absence of coverage by the French statutory health care insurance system
  • Surgery within the last 6 days
  • Use of vasopressors (norepinephrine\>0.3 mcg/kg/min)
  • Glasgow coma scale \< 13
  • Urgent need for endotracheal intubation
  • Patients at an end-of-life stage receiving compational oxygenation

Key Trial Info

Start Date :

September 1 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

March 1 2027

Estimated Enrollment :

1084 Patients enrolled

Trial Details

Trial ID

NCT06213168

Start Date

September 1 2024

End Date

March 1 2027

Last Update

July 19 2024

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