- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04468126
Standard Oxygen Versus High Flow Nasal Cannula Oxygen Therapy in Patients With Acute Hypoxemic Respiratory Failure (SOHO)
November 2, 2023 updated by: Poitiers University Hospital
Impact on Mortality of an Oxygenation Strategy Including Standard Oxygen Versus High Flow Nasal Cannula Oxygen Therapy in Patients With Acute Hypoxemic Respiratory Failure: a Prospective, Randomized Controlled Trial.
First-line therapy of patients with acute respiratory failure consists in oxygen delivery through standard oxygen, high-flow nasal oxygen therapy through cannula or non-invasive ventilation.
Non-invasive ventilation in acute hypoxemic respiratory failure is not recommended.
In a large randomized controlled study, high-flow nasal oxygen has been described as superior to non-invasive ventilation and standard oxygen in terms of mortality but not of intubation.
Paradoxically in immunocompromised patients, high-flow nasal oxygen has not been shown to be superior to standard oxygen.
To improve the level of evidence of daily clinical practice, we propose comparing high-flow nasal oxygen versus standard oxygen, in terms of mortality in all patients with acute hypoxemic respiratory failure
Study Overview
Status
Recruiting
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
1110
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 Contact
- Name: Jean-Pierre FRAT, PhD
- Phone Number: +33 05 49 44 60 64
- Email: jean-pierre.frat@chu-poitiers.fr
Study Contact Backup
- Name: Céline DELETAGE, PhD
- Phone Number: +33 05 49 44 38 54
- Email: celine.deletage@chu-poitiers.fr
Study Locations
-
-
-
Poitiers, France, 86000
- Recruiting
- CHU Poitiers
-
Contact:
- Jean-pierre FRAT, Dr
- Phone Number: +33-5-49-44-40-07
- Email: jean-pierre.frat@chu-poitiers.fr
-
-
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
Description
Inclusion Criteria:
All consecutive patients older than 18 years with an acute hypoxemic respiratory failure will be enrolled if they meet all the following criteria:
- Respiratory rate >25 breaths/min whatever the oxygen support
- Pulmonary infiltrate,
- PaO2/FiO2 ≤200 mmHg
- Informed consent from the patient or relatives.
Exclusion Criteria:
- PaCO2 > 45 mm Hg
- Need for emergent intubation: pulse oximetry < 90% with maximum oxygen support, respiratory arrest, cardiac arrest, or Glasgow coma scale below 8 points
- Hemodynamic instability defined by signs of hypoperfusion or use of vasopressors > 0.3 µg/kg/min
- Glasgow coma scale equal to or below 12 points
- Exacerbation of chronic lung disease including chronic obstructive pulmonary disease (grade 3 or 4 of Gold classification), or another chronic lung disease with long term oxygen or ventilatory support
- Cardiogenic pulmonary edema as main reason for acute respiratory failure
- Coronavirus SARS-2 infection as reason for acute respiratory failure (the SOHO-COVID study has been completed)
- Post-extubation respiratory failure within 7 days after extubation,
- Post-operative patients within 7 days after abdominal or cardiothoracic surgery,
- Do not intubate order;
- Already included in the study, refusal to participate or participation in another interventional study with the same primary outcome.
- Patients without any healthcare insurance scheme or not benefiting from it through a third party,
- Persons under law protection, namely minors, pregnant or breastfeeding women, persons deprived of their liberty by a judicial or administrative decision.
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: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: standard oxygen group
In order to maintain SpO2 between 92 and 96%
|
Standard low flow oxygen therapy through facemask or non-rebreathing mask at least 10 L/min.
|
Experimental: high-flow nasal cannula oxygen group
At least 50 L/min adjusted in order to maintain SpO2 between 92 and 96 %
|
Humidified and heated oxygen with a gas flow at least 50 l/min through nasal cannula and inspired fraction of oxygen adjusted in order to maintain a SpO2 between 92 and 96%
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mortality at 28 days after randomization
Time Frame: Day 28
|
Death between randomization and 28 days after randomization
|
Day 28
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Failure of the oxygenation strategy between randomization and D28
Time Frame: Day 28
|
Intubation between randomization and D28
|
Day 28
|
Mortality in ICU, in hospital, and day 90
Time Frame: Day 90
|
Death between randomization and end of stay in ICU, hospital.
Death between randomization and day 90.
|
Day 90
|
Number of ventilation free days at Day 28
Time Frame: Day 28
|
days alive and without intubation between day 1 and day 28
|
Day 28
|
Duration of ICU and hospital stay
Time Frame: Day 90
|
ICU and hospital stay between randomisation and end of stay in ICU and hospital
|
Day 90
|
Complications during the ICU stay
Time Frame: Day 90
|
Complications during the ICU stay include: septic shock, nosocomial pneumonia, cardiac arrhythmia, and cardiac arrest.
|
Day 90
|
Dyspnea
Time Frame: Hour 6
|
feeling is evaluated using a 5-point Likert scale, indicating marked improvement (+2), slight improvement (+1), no change (0), slight deterioration (-1) and marked deterioration (-2)
|
Hour 6
|
Comfort
Time Frame: Hour 6
|
comfort is evaluated using a 100-mm visual-analogue scale, from 0, i.e. "no discomfort", to100, i.e. "maximal imaginable discomfort"
|
Hour 6
|
Level of oxygenation
Time Frame: Hour 48
|
Oxygenation is assessed by arterial blood gas sample
|
Hour 48
|
Organ Failure during the 48 hours after intubation.
Time Frame: Day 28
|
Organ failure is evaluated by the Sepsis-related Organ Failure Assessment (SOFA) score during the 48 hours after intubation.
|
Day 28
|
Duration between the time when prespecified criteria of intubation are met and intubation
Time Frame: Day 28
|
interval between the time when prespecified criteria of intubation are met and intubation
|
Day 28
|
Duration between treatment initiation and intubation
Time Frame: Day 28
|
Interval between treatment initiation and intubation
|
Day 28
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Jean-Pierre FRAT, PhD, CHU Poitiers
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 (Actual)
January 19, 2021
Primary Completion (Estimated)
October 17, 2024
Study Completion (Estimated)
December 18, 2024
Study Registration Dates
First Submitted
July 8, 2020
First Submitted That Met QC Criteria
July 8, 2020
First Posted (Actual)
July 13, 2020
Study Record Updates
Last Update Posted (Estimated)
November 3, 2023
Last Update Submitted That Met QC Criteria
November 2, 2023
Last Verified
November 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- SOHO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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