- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01047852
Noninvasive Ventilation After Extubation in Hypercapnic Patients (VHYPER)
March 4, 2015 updated by: University Hospital, Bordeaux
Sequential and Early Used of Noninvasive Ventilation After Extubation in Hypercapnic Patients or in Patients With Chronic Respiratory Disorders
The purpose of this study is to assess the efficacy of noninvasive ventilation (NIV) in the prevention of extubation failure and mortality in patients with either chronic respiratory disorders or hypercapnic respiratory failure during spontaneous breathing.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Reintubation, which occurs in 6 to 23% within 48 to 72 hours after planned extubation, is a relevant consequence of respiratory failure after extubation.
Patients with chronic respiratory disorders and invasively mechanically ventilated in intensive care unit, often exhibit hypercapnia, during breathing trial prior extubation.
This is associated to increased incidence of extubation failure and mortality.
Although the need for reintubation may be a marker of increased severity of illness, this is an independent risk factor for nosocomial pneumonia, increased hospital stay and mortality.
NIV does not seem to be beneficial in avoiding reintubation when these patients have developed respiratory failure.
However, a recent randomised study demonstrated that the early use of NIV averted respiratory failure after extubation in patients at increased risk.
The patients were considered at risk if they had at least one of the following criteria: age > 65 years, cardiac failure, increased severity assessed by an Acute Physiologic and Chronic Health Evaluation score > 12. But, the beneficial effects of NIV on survival appear to be restricted to patients with chronic respiratory disorders and hypercapnia during the spontaneous breathing trial.
So the beneficial effects of NIV should be confirmed in a trial in this specific population.
We planned to conduct a study evaluating the efficacy of NIV in the prevention of extubation failure and mortality in these patients.
If no signs of respiratory failure appeared after 120 min of a spontaneous breathing trial, patients will be extubated and randomly allocated after extubation to NIV group or control group.
The clinical follow-up will be as follow: the incidence of extubation failure, the reintubation, the ICU and hospital mortality, 28-day survival, the complications associated to mechanical ventilation, ICU and hospital length of stay.
Study Type
Interventional
Enrollment (Actual)
144
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Agen, France, 47923
- Hospital
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Bordeaux, France, 33075
- Saint-André Hospital
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Bordeaux, France, 33076
- Pellegrin Hospital, Recovery Unit
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Libourne, France, 33505
- Hospital
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Limoges, France, 87042
- University Hospital
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Toulouse, France, 31059
- University Hospital
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients intubated for 48 hours or more
- Patients with Chronic respiratory disorders
- And/or hypercapnic respiratory failure during successful spontaneous breathing trial
Exclusion Criteria:
- Face or cranial trauma or surgery
- Home noninvasive ventilation
- Recent gastric or oesophageal surgery
- Tracheostomy or other upper airway disorders
- Upper gastrointestinal bleeding
- Excess respiratory secretions
- Lack of collaboration
- Do not resuscitate order or any decision to limit therapeutic effort in the ICU.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Control
|
|
Experimental: NIV
|
NIV will be delivered using a sequential mode (a minimum of 1 hour every 3 hours) immediately after extubation for a schedule period of 48 h after extubation.
In between NIV courses ((NIV-free periods) O2 will be administered through nasal cannula in order to obtain a SaO2 ≥ 90%.
Afterward, NIV will be withdraw and oxygen will be administered by nasal cannula
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Incidence of respiratory failure after extubation
Time Frame: 2 days
|
2 days
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Incidence of reintubation
Time Frame: 2 months
|
2 months
|
Length of stay in Intensive Care Unit
Time Frame: 2 months
|
2 months
|
Hospital mortality
Time Frame: 2 months
|
2 months
|
Survival
Time Frame: 28th day
|
28th day
|
Survival
Time Frame: 90th day
|
90th day
|
Incidence of complications associated to mechanical ventilation
Time Frame: 2 months
|
2 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Frédéric VARGAS, MD, University Hospital, Bordeaux, France
- Principal Investigator: Olivier GUISSET, MD, University Hospital, Bordeaux, France
- Principal Investigator: Marc CLAVEL, MD, University Hospital, Limoges, France
- Principal Investigator: Pascale SANCHEZ, MD, University Hospital, Toulouse, France
- Principal Investigator: Sylvain GARNIER, MD, Hospital, Libourne, France
- Principal Investigator: Aissa KHERCHACHE, MD, Hospital, Agen, France
- Study Chair: Antoine BENARD, MD, University Hospital, Bordeaux, France
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
January 1, 2010
Primary Completion (Actual)
May 1, 2011
Study Completion (Actual)
August 1, 2011
Study Registration Dates
First Submitted
January 5, 2010
First Submitted That Met QC Criteria
January 12, 2010
First Posted (Estimate)
January 13, 2010
Study Record Updates
Last Update Posted (Estimate)
March 5, 2015
Last Update Submitted That Met QC Criteria
March 4, 2015
Last Verified
March 1, 2015
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CHUBX 2009/10
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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