Fibreoptic Bronchoscopy Assisted Intubation During Noninvasive Positive Pressure Ventilation (FBAIDNIPPV)

Lingbo Nong

Status: Completed

Conditions: Respiratory Failure

Treatments: Procedure: Noninvasive positive pressure ventilation(NIPPV); Procedure: fibreoptic bronchoscopy assisted intubation; Procedure: Bag-mask ventilation

Study type: Interventional

Funder types: Other

Identifiers

NCT02462668

LNong

Details and patient eligibility

About

This study is to investigate the efficiency and safety of fibreoptic bronchoscopy assisted intubation during noninvasive positive pressure ventilation in respiratory failure patients. Half of the participants will receive preoxygenation with noninvasive ventilator and fibreoptic bronchoscopy intubation during NIPPV. While the other half using usual preoxygenation(bag-mask ventilation ).

Full description

Respiratory failure is very common for critically ill patients, Main complication associated with intubation was desaturation. Usual preoxygenation( bag-mask ventilation) have been show that marginally effective in critically ill patients. As a result, there is a need to optimize the technique of preoxygenation to prolong the safe duration of apnea during the intubation procedure in critically ill patients. Noninvasive ventilation provides continuous positive airway pressure is effective in increasing the efficiency of gas exchange and in reducing the decrease in oxyhemoglobin saturation during fiberoptic bronchoscopy in hypoxemic patients.

Therefore, our aim was to study whether NIPPV is more effective at reducing desaturation than usual preoxygenation in hypoxemic, critically ill patients requiring intubation in ICU.

Enrollment: 106 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Acute respiratory failure requiring intubation,
• Age greater than or equal to 18 years

Exclusion criteria

1. Nasal polyps，Nasopharyngeal cancer，Nasal bleeding，Rhinitis，Sinusitis and so on Nasal disease
2. Basal skull fracture
3. Severe coagulopathy, blood platelet counts <50×10*9/L
4. Nose and facial deformities, trauma
5. Cardiac arrest
6. Pregnancy or puerpera

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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106 participants in 2 patient groups, including a placebo group

Control

Placebo Comparator group

Description:

Preoxygenation with Bag-mask ventilation before fibreoptic bronchoscopy assisted intubation. Intervention: Bag-mask ventilation.

Treatment:

Procedure: fibreoptic bronchoscopy assisted intubation

Procedure: Bag-mask ventilation

NIPPV

Experimental group

Description:

The NIPPV group preoxygenation with noninvasive positive pressure ventilation(NIPPV), And then receives fibreoptic bronchoscopy intubation through a face mask (there is a small hole allow to insert the tracheal tube through the mask into trachea) during NIPPV. Intervention: noninvasive positive pressure ventilation(NIPPV)

Treatment:

Procedure: fibreoptic bronchoscopy assisted intubation

Procedure: Noninvasive positive pressure ventilation(NIPPV)