Wean Early With HFNCO vs NPPV in Patients With AHRF

Capital Medical University

Status: Unknown

Conditions: Patients With Acute Hypoxemic Respiratory Failure

Treatments: Device: Noninvasive Positive Pressure Ventilation; Device: Conventional weaning; Device: High-Flow Nasal Cannula Oxygenation

Study type: Interventional

Funder types: Other

Identifiers

NCT03171935

BeijingCYH-ICU-005

Details and patient eligibility

About

The main purpose of the present study is to verify whether, as compared with conventional weaning, early weaning with high-flow nasal cannula oxygenation or noninvasive positive pressure ventilation may more effective in shortening the duration of invasive ventilation, hence reducing the rates of complications and mortality in patients with acute hypoxemic respiratory failure.

Enrollment: 270 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Orotracheal intubation；
2. PaO2 <60mmHg（venturi mask，FiO2=0.5），and PaCO2 ≤45mmHg；
3. Meeting criteria for weaning readiness；
4. Spontaneous breathing trial failure.

Exclusion criteria

1. Age<18；
2. Duration of invasive ventilation <48h；
3. Tracheotomy；
4. Percentage of cuff leak volume in tidal volume<15.5%；
5. Unable to spontaneously clear secretions from their airway；
6. Recent oral，nasal，facial or cranial trauma or surgery；
7. Recent gastric or esophageal surgery；
8. Active upper gastro-intestinal bleeding；
9. Severe abdominal distension；
10. Lack of co-operation；
11. Chronic respiratory disease such as chronic obstructive pulmonary disease, asthma, interstitial lung disease and neuromuscular disease.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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270 participants in 3 patient groups

High-Flow Nasal Cannula Oxygenation

Experimental group

Treatment:

Device: High-Flow Nasal Cannula Oxygenation

Noninvasive Positive Pressure Ventilation

Experimental group

Treatment:

Device: Noninvasive Positive Pressure Ventilation

Conventional Weaning

Active Comparator group

Treatment:

Device: Conventional weaning