- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02214368
Noninvasive Ventilation Bundle in Postoperative Respiratory Failure
The Efficacy and Safety of Noninvasive Ventilation Bundle in Postoperative Respiratory Failure
Study Overview
Status
Conditions
Detailed Description
This is a randomized, prospective, open-label study. Postoperative patients with ARF included in the study were randomly assigned to intervention group or conventional treatment group. In the intervention group, NIV was early used for treatment of postoperative respiratory failure, if patients were inability to spontaneously clear airways from excessive secretions during NIV, fiberoptic bronchoscopy (FBO) was used for suction of secretions , if patients showed intolerance or inadequate patient cooperation during the NIV session, they were sedated (Ramsay scale 2-3) by a continuous perfusion of propofol during the NIV session.
Patients assigned to the control group received supplemental oxygen, Respiratory therapists delivered this intervention using conventional masks or venturi oxygen, and adjusted FiO2 to achieve arterial O2 saturation of more than 92%. The application of noninvasive ventilation was considered, if patients failed the supplemental oxygen and met at least two of the following criteria:(1) severe respiratory distress with dyspnoea, respiratory rate>30breaths/min, and clinical signs suggestive of respiratory-muscle fatigue or increased respiratory effort (use of accessory respiratory muscles or paradoxical abdominal breathing, or intercostal indrawing), (2) respiratory acidosis (arterial pH of 7.35 or less with PaCO2 of 45 mm Hg or more) ;(3) arterial O2 saturation by pulse oximetry less than 90% or PaO2 less than 60 mm Hg at an FiO2> 0.5 or breathing at least 10 l/min oxygen.
All the patients were continuous monitored of vital signs.whereas arterial blood gases were analyzed before NIV and 1h after NIV, before and after FBO, and once a day and in the case of any change either in the ventilatory settings or in the FIO2; duration of noninvasive ventilation, the rate and cause of endotracheal intubation, ICU and hospital mortality and length of stay in the ICU and in hospital, study procedure related complications.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Sichuan
-
Chengdu, Sichuan, China, 610041
- Department of Critical care medicine of West China Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Postoperative patients with acute respiratory failure (ARF) were included in the study,who had to meet one of the following criteria
- Respiratory acidosis (arterial pH of 7.35 or less with PaCO2 of 45 mm Hg or more)
- Partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio less than 250
- Dyspnoea with respiratory rate > 25 breaths/min or use of accessory respiratory muscles or paradoxical abdominal breathing
Exclusion Criteria:
- Cardiac or respiratory arrest; loss of consciousness
- Facial trauma or surgery or deformity sufficient to preclude mask fitting
- Active upper gastrointestinal bleeding
- Haemodynamic instability or unstable cardiac arrhythmia
- Multiple organ failure
Study Plan
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 |
---|---|
Experimental: NIV bundle group
early use of NIV, and combination fiberoptic bronchoscopy and sedation
|
Device:BiPAP Vision. NIV bundle group : Early application of NIV(BiPAP Vision) in 1 h after randomization.
Other Names:
Device:fiberoptic bronchoscopy.
NIV bundle group :When patients were inability to spontaneously clear airways from excessive secretions during NIV, fiberoptic bronchoscopy (FBO) was used for suction of secretions.
Drug:propofol.continuous perfusion of propofol (0.50-2.00 mg/kg/h). NIV bundle group :When patients showed intolerance or inadequate patient cooperation during the NIV session, they were sedated (Ramsay scale 2-3) by a continuous perfusion of propofol (0.50-2.00 mg/kg/h). In the conventional treatment group: No intervention.
Other Names:
|
Other: Conventional treatment group
standard supplemental oxygen, and conventional application of noninvasive ventilation.
|
Conventional treatment group:NIV(BiPAP Vision) was used, when patients failed the supplemental oxygen and met at least two of the following criteria:(1) severe respiratory distress with dyspnoea, respiratory rate>30breaths/min, and clinical signs suggestive of respiratory-muscle fatigue or increased respiratory effort (use of accessory respiratory muscles or paradoxical abdominal breathing, or intercostal indrawing), (2) respiratory acidosis (arterial pH of 7.35 or less with PaCO2 of 45 mm Hg or more) ;(3) arterial O2 saturation by pulse oximetry less than 90% or PaO2 less than 60 mm Hg at an FiO2> 0.5 or breathing at least 10 L/min oxygen.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
the need of endotracheal intubation
Time Frame: 7 days
|
7 days
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Y F Zhou, MM, Department of Critical care medicine of West China Hospital
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- YB20130097
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.
Clinical Trials on Respiratory Insufficiency
-
Hospital Israelita Albert EinsteinRecruitingRespiratory Insufficiency in ChildrenBrazil
-
Vyaire MedicalCompletedRespiratory Insufficiency in ChildrenUnited Kingdom, Poland, Netherlands
-
The Affiliated Hospital of Qingdao UniversityNot yet recruitingRespiratory Insufficiency Requiring Mechanical VentilationChina
-
Vyaire MedicalCompletedRespiratory Insufficiency in ChildrenNetherlands, Poland
-
Shanghai 10th People's HospitalUnknownPatients With Respiratory InsufficiencyChina
-
Erasme University HospitalCentre Hospitalier Régional de la CitadelleNot yet recruitingRespiratory Insufficiency Requiring Mechanical VentilationBelgium
-
Fondazione Salvatore MaugeriAzienda Ospedaliero, Universitaria Pisana; Ataturk Training and Research HospitalCompletedChronic Respiratory InsufficiencyItaly
-
ADIR AssociationSuspendedCOPD | Chronic Respiratory InsufficiencyFrance
-
University Hospital, BordeauxCompletedRespiratory Failure | Acute Respiratory InsufficiencyFrance
-
Yolanda Lopez FernandezHospital Infantil Universitario Niño Jesús, Madrid, Spain; Dr. Negrin University... and other collaboratorsRecruitingAcute Respiratory InsufficiencySpain
Clinical Trials on Early application of NIV
-
Hospital General Universitario Morales MeseguerNot yet recruitingEvaluation of Prone Position Effect During NIV and HFNC on Acute Hypoxemic Respiratory Failure
-
Columbia UniversityALS AssociationTerminatedAmyotrophic Lateral Sclerosis (ALS)United States
-
University Hospital, GrenobleHôpital Raymond Poincaré; Association Française contre les Myopathies (AFM)...CompletedNeuromuscular Diseases | Alveolar HypoventilationFrance
-
IP Santé DomicileUnknown
-
Guy's and St Thomas' NHS Foundation TrustRecruitingSleep Disordered Breathing | COPD | Hypercapnic Respiratory Failure | Obesity Hypoventilation Syndrome (OHS)United Kingdom
-
University Hospital, RouenCompletedCopd | COPD ExacerbationFrance
-
Chinese University of Hong KongThe Queen Elizabeth HospitalUnknown
-
University Hospital, GrenobleAGIR à Dom; Philips HealthcareTerminated
-
University of UlsterCompletedBronchiectasisUnited Kingdom
-
University Medical Center GroningenCompletedChronic Obstructive Pulmonary DiseaseNetherlands