Study Comparing Two Ventilation Modes NAVA (Neurally Adjusted Ventilatory Assist) Mode and Spontaneous Breathing With Inspiratory Pressure Support (IPS) Mode in Consecutive Patients Hospitalized for Acute Respiratory Failure Requiring Mechanical Ventilation With Endotracheal Tube.
ZEPHYR: Multicenter, Prospective, Randomized, Open-label Study in Consecutive Patients Hospitalized for Acute Respiratory Failure Requiring Mechanical Ventilation With Endotracheal Tube. This Study Compared Two Ventilation Modes: NAVA Mode and Spontaneous Breathing With Inspiratory Pressure Support (the Latter is Considered as the Reference Ventilation Mode).
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
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Alpes Maritimes
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Nice, Alpes Maritimes, Frankrig, 06202
- Hôpital l'Archet 1
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Gironde
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Bordeaux, Gironde, Frankrig, 33076
- Hôpital Pellegrin
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Pessac, Gironde, Frankrig, 33604
- Groupe Hospitalier Sud - Hôpital Haut-Leveque - Maison du Haut-Leveque
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Haute Vienne
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Limoges, Haute Vienne, Frankrig, 87042
- Hopital Dupuytren
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Herault
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Montpellier, Herault, Frankrig, 34295
- Hopital Saint-Eloi - CHU MONTPELLIER
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Ile de France
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Paris, Ile de France, Frankrig, 75651
- Hôpital de la Pitié Salpêtrière
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Maine Et Loire
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Angers, Maine Et Loire, Frankrig, 49933
- Hopital Larrey- CHU D'ANGERS
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Normandie
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Caen, Normandie, Frankrig, 14000
- Hopital de la Cote de Nacre - CHU de CAEN
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Puy de Dome
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Clermont Ferrand, Puy de Dome, Frankrig, 63100
- Hôpital d'Estaing
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Rhone Alpes
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Lyon, Rhone Alpes, Frankrig, 69004
- Hôpital de La Croix Rousse
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Lyon, Rhone Alpes, Frankrig, 69495
- Centre Hospitalier LYON SUD
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Patient ventilated with endotracheal tube for more than 24 hours
- Return for at least 30 minutes to spontaneous ventilation allowing IPS with a level of pressure support <30 cm H2O;
- Level of sedation =< 4 on the Ramsay scale in the absence of medical decision to increase the level of sedation;
- Fraction of inspired oxygen (FiO 2) =< 50% with a positive end-expiratory pressure (PEEP) =< 8 cm H2O;
Absence of administration of high-dose vasopressor therapy defined by:
- norepinephrine > 0.3 mcg / kg / min;
- dopamine > 10 mcg / kg / min;
- Estimated duration of mechanical ventilation > 48h00
Exclusion Criteria:
Contraindication to the implementation of the NAVA endotracheal tube, ie any contraindication to the implementation of a gastric tube or to the repositioning of a tube already in place:
- Recent gastrointestinal suture ;
- Esophageal varices rupture with gastrointestinal bleeding within 4 days prior to inclusion;
- Therapeutic limitation or active treatment discontinuation;
- Pregnant women;
- Minors;
- Protected adults;
- Patient already included in the study;
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Støttende pleje
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: spontaneous NAVA mode
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Aktiv komparator: Inspiratory pressure support (IPS)
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Evaluate the benefit of NAVA mode as compared to IPS mode in terms of duration of spontaneous ventilation 48 hours after inclusion.
Tidsramme: Continuous recording during 48 hours following the intubation
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The time spent in different modes of spontaneous ventilation (NAVA, IPS) and controlled ventilation (VAC controlled pressure) will be measured.
The primary endpoint will be the proportion of patients remaining in spontaneous ventilation after the first 48 hours.
|
Continuous recording during 48 hours following the intubation
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Reduction of patient / ventilator disharmony, measured during the first 48 hours with the disharmony index
Tidsramme: Continuous recording during the first 48 hours
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Continuous recording during the first 48 hours
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Real-time spent in NAVA mode and frequency of returns in a controlled mode (controlled ventilation VAC).
Tidsramme: Continuous recording during the first 48 hours
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Feasibility of the initiation of mechanical ventilation in NAVA mode and feasibility of prolonged mechanical ventilation in NAVA mode
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Continuous recording during the first 48 hours
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Earnings on the "breathing comfort"
Tidsramme: Continuous recording during the first 48 hours
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Continuous recording during the first 48 hours
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Earnings on sleep architecture
Tidsramme: Continuous recording during the first 48 hours
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Total sleep time; Number of arousals per hour; Duration of stage IV sleep ; Duration of Rapid Eye Movement (REM) sleep.
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Continuous recording during the first 48 hours
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Tolerance
Tidsramme: Continuous for the duration of ICU stay, an expected maximum of 14 days
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Continuous for the duration of ICU stay, an expected maximum of 14 days
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Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Number of implementation failure of the NAVA endotracheal tube.
Tidsramme: For each patient, the success or failure of the endotracheal tube implementation will be evaluated, this for the entire duration of the study estimated to 18 months
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For each patient, the success or failure of the endotracheal tube implementation will be evaluated, this for the entire duration of the study estimated to 18 months
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Number and duration of automatic switch into IPS mode
Tidsramme: Continuous recording until extubation or D14 maximum
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Continuous recording until extubation or D14 maximum
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Number of Permanent discontinuation of NAVA ventilation mode
Tidsramme: Continuous recording during the first 48 hours
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Continuous recording during the first 48 hours
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Comfort of the device measured by a visual analog scale.
Tidsramme: At the extubation or at D14 maximum
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Tolerance of the device
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At the extubation or at D14 maximum
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Side effects associated with the use of the system
Tidsramme: Continuous for the duration of ICU stay, an expected maximum of 14 days
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Device movements Endotracheal tube obstruction Lesion of the oral or nasal mucosa
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Continuous for the duration of ICU stay, an expected maximum of 14 days
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- N° 2011-001
- 2011-A00559-32 (Anden identifikator: ANSM)
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