High-flow nasal therapy versus noninvasive ventilation in COPD patients with mild-to-moderate hypercapnic acute respiratory failure: study protocol for a noninferiority randomized clinical trial.


Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
22 Jul 2019
Historique:
received: 29 03 2019
accepted: 10 06 2019
entrez: 24 7 2019
pubmed: 25 7 2019
medline: 6 2 2020
Statut: epublish

Résumé

Noninvasive ventilation (NIV) is indicated to treat respiratory acidosis due to exacerbation of chronic obstructive pulmonary disease (COPD). Recent nonrandomized studies also demonstrated some physiological effects of high-flow nasal therapy (HFNT) in COPD patients. We designed a prospective, unblinded, multicenter, randomized controlled trial to assess the noninferiority of HFNT compared to NIV with respect to the reduction of arterial partial pressure of carbon dioxide (PaCO We will enroll adult patients with acute hypercapnic respiratory failure, as defined by arterial pH between 7.25 and 7.35 and PaCO HFNT is more comfortable than NIV in COPD patients recovering from an episode of exacerbation. If HFNT would not be inferior to NIV, HFNT could be considered as an alternative to NIV to treat COPD patients with mild-to-moderate respiratory acidosis. ClinicalTrials.gov, NCT03370666 . Registered on December 12, 2017.

Sections du résumé

BACKGROUND BACKGROUND
Noninvasive ventilation (NIV) is indicated to treat respiratory acidosis due to exacerbation of chronic obstructive pulmonary disease (COPD). Recent nonrandomized studies also demonstrated some physiological effects of high-flow nasal therapy (HFNT) in COPD patients. We designed a prospective, unblinded, multicenter, randomized controlled trial to assess the noninferiority of HFNT compared to NIV with respect to the reduction of arterial partial pressure of carbon dioxide (PaCO
METHODS METHODS
We will enroll adult patients with acute hypercapnic respiratory failure, as defined by arterial pH between 7.25 and 7.35 and PaCO
DISCUSSION CONCLUSIONS
HFNT is more comfortable than NIV in COPD patients recovering from an episode of exacerbation. If HFNT would not be inferior to NIV, HFNT could be considered as an alternative to NIV to treat COPD patients with mild-to-moderate respiratory acidosis.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov, NCT03370666 . Registered on December 12, 2017.

Identifiants

pubmed: 31331372
doi: 10.1186/s13063-019-3514-1
pii: 10.1186/s13063-019-3514-1
pmc: PMC6647141
doi:

Banques de données

ClinicalTrials.gov
['NCT03370666']

Types de publication

Clinical Trial Protocol Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

450

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Auteurs

Andrea Cortegiani (A)

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Via del vespro 129, 90127, Palermo, Italy. andrea.cortegiani@unipa.it.

Federico Longhini (F)

Intensive Care Unit, Department of Medical and Surgical Sciences, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy.

Annalisa Carlucci (A)

Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri, Pavia, Italy.

Raffaele Scala (R)

Pulmonology and Respiratory Intensive Care Unit, S. Donato Hospital, Arezzo, Italy.

Paolo Groff (P)

Emergency Department, "S. Maria della Misericordia" Hospital, Perugia, Italy.

Andrea Bruni (A)

Intensive Care Unit, Department of Medical and Surgical Sciences, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy.

Eugenio Garofalo (E)

Intensive Care Unit, Department of Medical and Surgical Sciences, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy.

Maria Rita Taliani (MR)

Emergency Department, "S. Maria della Misericordia" Hospital, Perugia, Italy.

Uberto Maccari (U)

Pulmonology and Respiratory Intensive Care Unit, S. Donato Hospital, Arezzo, Italy.

Luigi Vetrugno (L)

Department of Anaesthesia and Intensive Care, University of Udine, Udine, Italy.

Enrico Lupia (E)

Emergency Department, "Città della Salute e della Scienza" University Hospital, Torino, Italy.

Giovanni Misseri (G)

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Via del vespro 129, 90127, Palermo, Italy.

Vittoria Comellini (V)

Department of Clinical, Integrated and Experimental Medicine (DIMES), Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy.

Antonino Giarratano (A)

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Via del vespro 129, 90127, Palermo, Italy.

Stefano Nava (S)

Department of Clinical, Integrated and Experimental Medicine (DIMES), Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy.

Paolo Navalesi (P)

Intensive Care Unit, Department of Medical and Surgical Sciences, University Hospital Mater Domini, Magna Graecia University, Catanzaro, Italy.

Cesare Gregoretti (C)

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Via del vespro 129, 90127, Palermo, Italy.

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