The use of non-invasive respiratory assistance to facilitate bronchofiberoscopy performance in patients with hypoxemic (type one) respiratory failure - Study protocol.
Bronchofiberoscopy
High flow nasal oxygen therapy
Noninvasive ventilation
Respiratory failure
Journal
Advances in medical sciences
ISSN: 1898-4002
Titre abrégé: Adv Med Sci
Pays: Netherlands
ID NLM: 101276222
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
25
03
2023
revised:
04
10
2023
accepted:
25
10
2023
medline:
27
11
2023
pubmed:
10
11
2023
entrez:
9
11
2023
Statut:
ppublish
Résumé
Bronchofiberoscopy (FOB) is a procedure routinely performed for: lung cancer, obstruction, interstitial diseases, foreign bodies' removal, airway clearance, and hemoptysis. It causes acute airway narrowing leading to respiratory and cardiovascular stress. Due to increasing number of ill patients with respiratory failure (RF), conventional oxygen therapy (COT) is frequently insufficient to assure accurate oxygenation and prevent RF in patients requiring FOB. In this clinical scenario, patients may be intubated and supported with invasive mechanical ventilation (IMV) with the specific aim of allowing a safe FOB. However, this invasive strategy is associated with an increased risk of IMV-associated complications. Our study is a planned prospective multicenter three-arm randomized controlled trial (RCT). The target number of 300 patients was calculated based on the intubation risk in RF patients, which is 0.2-2%. The patients will be assigned to each arm based on Horowitz index. In each arm, the patients will be randomly assigned to one out of two dedicated respiratory support methods in each group i.e. COT/high flow nasal cannula (HFNC), HFNC/non-invasive ventilation (NIV) and NIV/IMV. In the manuscript the current state of art in the area of respiratory support is discussed. We have underlined knowledge gaps in medical evidence which we are planning to reveal with our results. The results of our study are clinically crucial, because they address current gaps concerning COT/HFNC/NIV/IMV. The expected findings of this study would allow for careful selection of respiratory support method to safely perform FOB in patients with hypoxemic RF.
Identifiants
pubmed: 37945440
pii: S1896-1126(23)00051-2
doi: 10.1016/j.advms.2023.10.011
pii:
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Clinical Trial Protocol
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
474-481Informations de copyright
Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare no conflict of interests.