Effect of Postextubation High-Flow Nasal Cannula vs Noninvasive Ventilation in Patients With Hypercapnic COPD

Central South University

Status: Unknown

Conditions: COPD; High-Flow Nasal Cannula

Treatments: Device: Noninvasive Ventilation; Device: High-FlowNasal Cannula

Study type: Interventional

Funder types: Other

Identifiers

NCT03928535

261358454

Details and patient eligibility

About

To test if high-flow conditioned oxygen therapy is noninferior to NIV for preventing postextubation respiratory failure and reintubation in patients with hypercapnic COPD, investigators plan to conduct the participants level, 1:1 randomized trial at the respiratory ICU. Participants were randomized to undergo either high-flow conditioned oxygen therapy or noninvasive mechanical ventilation after extubation. Primary outcomes were reintubation and postextubation respiratory failure within 72 hours. Secondary outcomes included length of RICU stay after extubation and mortality; partial pressure of arterial carbon dioxide.

Enrollment: 100 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Clinical diagnosis of AECOPD
• Extubation must be performed after 48 hours of invasive ventilation
• Must be treated sequentially with HFNC or NIV after extubation
• PaCO2≥50mmHg when extubation
• Positive End Expiratory Pressure (PEEP) ≤8cmH2O (1cmH2O=0.098 kPa) when extubation

Exclusion criteria

• Do-not-intubate
• Tracheostomies
• Accidental extubation
• Self-extubation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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100 participants in 2 patient groups

High-Flow Nasal Cannula

Other group

Description:

High-flow oxygen was applied immediately after extubation through specific nasal cannula.

Treatment:

Device: High-FlowNasal Cannula

Noninvasive Ventilation

Other group

Description:

Noninvasive Ventilation was applied immediately after extubation.

Treatment:

Device: Noninvasive Ventilation