Impact of High-level Oxygen Therapy on the Reconditioning of Type I Hypoxemic Respiratory Insufficiency Patients in Intensive Care

Dr David DE BELS

Status: Completed

Conditions: Hypoxemic Respiratory Failure

Treatments: Device: Cyclometer Ergometer

Study type: Interventional

Funder types: Other

Identifiers

NCT04022603

CHUB-BPCO

Details and patient eligibility

About

High-throughput oxygen therapy is known as an alternative to non-invasive ventilation, with a benefit in terms of survival in non-hypercapnic respiratory failure patients.

The use of high-throughput oxygen therapy is well studied in stable chronic obstructive pulmonary disease (COPD) patients and has as known effects the decrease of transcutaneous CO2 and respiratory rate, and the increase in the inspiratory/expiratory time report, in the tidal volume and in the forced expiratory volume per second.

In the event of an exacerbation, high-flow oxygen therapy has shown to be beneficial in terms of increased mean airway pressure, tidal volume with a decrease in hypercapnia, and respiratory rate.

The net effect on the CO2 pressure is linked to the CO2 clearance of the dead anatomical space by the high throughput. The effect can be compared with the one of non invasive ventilation in a stable COPD patient.

Oxygen therapy, even in patients with non-hypoxic COPD at rest, has benefits in terms of performance and improvement of quality of life. High-throughput oxygen therapy has also shown a benefit in COPD patients in revalidation units, in terms of exercise performance and oxygenation.

However, the reconditioning of critical patients in acute situations, by means of nasal goggles, has never been studied.

Enrollment: 30 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Acute respiratory insufficiency type I, oxygen partial pressure (PaO2) <60 mmHg under oxygen without hypercapnia.
• Invasive arterial pressure measure

Exclusion criteria

• Hemodynamic instability
• Patient under continuous high throughput oxygen therapy
• Left cardiac insufficiency
• Arteritis of the lower limbs
• Neuromuscular pathology
• Osteo-articular limitations
• Hemoglobin inferior to 8g/dl

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

Optiflow nasal googles

Experimental group

Description:

Oxygen provided by means of high throughput nasal googles (Optiflow, Fisher\&Paykel- New Zealand).

Treatment:

Device: Cyclometer Ergometer

Venturi mask

Active Comparator group

Description:

Oxygen provided by means of a Venturi mask.

Treatment:

Device: Cyclometer Ergometer