Comparison of Non-invasive Oxygenation Strategies in Patients Admitted for Covid-19 Acute Respiratory Distress Syndrome (SONIC-19)

Intermunicipal Hospital Center Toulon

Status: Completed

Conditions: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Treatments: Other: Use of High Flow Nasal Cannula alone; Other: Use of Continuous Positive Airway Pressure; Other: Use of Non-invasive Ventilation

Study type: Observational

Funder types: Other

Identifiers

NCT04725084

2021-CHITS-001

Details and patient eligibility

About

Acute Respiratory Distress Syndrome (ARDS) is the main clinical presentation of SARS-CoV-2 (Covid-19) infected patients admitted in Intensive Care Unit (ICU).

During the first phase of the outbreak (between February and May 2020), the use of invasive Mechanical Ventilation (MV) was largely required with 63% of ICU patients intubated in the first 24 hours after admission and up to 80% of patients during the overall ICU stay. Mortality was especially higher when using MV in the first 24 hours. In contrast, the use of non-invasive oxygenation strategies in the first 24 hours was only 19% for High Flow Nasal Cannula oxygen therapy (HFNC) and 6% for Non-Invasive Ventilation (NIV).

Several non-invasive oxygenation strategies were proposed in order to delay or avoid MV in ICU patients suffering from Covid-19 ARDS. The use of HFNC became the recommended oxygenation strategy, based in particular on publications prior to the outbreak. The use of NIV or Continuous Positive Airway Pressure (CPAP) combined with HFNC have also been proposed. Although these non-invasive oxygenation strategies seem widely used in the second phase of the outbreak, they have not yet confirmed their clinical impact on MV requirement and patient's outcome. Moreover, no comparison has been made between these different non-invasive oxygenation strategies.

The aim of this study is to compare different non-invasive oxygenation strategies (HFNC, NIV, CPAP) on MV requirement and outcome in ICU patients treated for ARDS related to Covid-19.

Full description

Retrospective multicenter observational registry in French intensive care unit including all consecutive patients admitted for acute respiratory distress syndrome related to SARS-CoV-2 pneumonia between1st July and 31th December 2020.

Patients characteristics, ICU treatments and outcome will be recorded.

Enrollment: 355 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients admitted in intensive care unit because of a SARS-CoV-2 infection confirmed by PCR wherever was collected the analyzed sample
• acute respiratory distress syndrome according to Berlin criteria
• age superior or equal to 18 years old

Exclusion criteria

• patient opposition to participate in the study
• patients under judicial protection measures

Trial design

355 participants in 3 patient groups

High Flow Nasal Cannula oxygen therapy treatment

Description:

Patients treated only by high flow nasal cannula oxygen therapy

Treatment:

Other: Use of High Flow Nasal Cannula alone

Non-Invasive Ventilation treatment

Description:

Patients treated by non-invasive ventilation (combined or not with HFNC)

Treatment:

Other: Use of Non-invasive Ventilation

Continuous Positive Airway Pressure treatment

Description:

Patients treated by continuous positive airway pressure (combined or not with HFNC)

Treatment:

Other: Use of Continuous Positive Airway Pressure