- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01699880
Efficacy of High Flow Nasal Cannula Oxygen to Reduce Desaturation During Tracheal Intubation (HAPI)
11. august 2014 opdateret af: Prof Jean-Damien RICARD, Hôpital Louis Mourier
High Flow Nasal Cannula Oxygen for Pre and During Procedure Oxygenation During Tracheal Intubation: Comparison With High FiO2 Non Rebreathing Bag Reservoir Facemasks
Tracheal intubation of critically ill patients is associated in the intensive care unit (ICU) with significant complications and morbidity.
Patient desaturation is one of the most common complications that may lead to cardiac arrest despite pre-intubation oxygenation.
Preoxygenation can be improved by the use of non-invasive ventilation, but this technique can be cumbersome to implement in the context of urgent intubation and more importantly it does not insure oxygenation during intubation.
High flow nasal cannula oxygen therapy is a technique that has been shown to improve patient oxygenation in the context of acute hypoxemic respiratory failure.
It bears the potential to be of clinical benefit in the setting of tracheal intubation in the ICU to ensure patient safety.
The purpose of this study is to compare pre- and per-intubation (during intubation) oxygenation with either a conventional high FiO2 oxygen bag reservoir facemask (current standard practice) or high flow nasal cannula oxygen therapy (new practice to be implemented in our ICU).
Studieoversigt
Status
Afsluttet
Detaljeret beskrivelse
Pre-oxygenation is ensured in our ICU with a high FiO2 nonrebreathing facemask, except in patients already under high flow nasal cannula oxygen therapy because of acute hypoxemic respiratory failure.
A nasal catheter is positioned to ensure a low oxygen flow during laryngoscopy.
Whether or not all patients should benefit from high flow nasal cannula oxygen therapy for pre-oxygenation remains unknown.
In order to improve quality of care delivered to our patients and in anticipation of a change in our practice, we decided to record prospectively oxygen parameters during and immediately of intubation using a facemask and to compare them with parameters obtained in patients intubated after our change in practice.
The change of practice consists in the systematic use of high flow nasal cannula oxygen therapy to ensure pre and during procedure (tracheal intubation)oxygenation.
Undersøgelsestype
Observationel
Tilmelding (Faktiske)
101
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Colombes, Frankrig, 92701
- Medico-surgical ICU
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
18 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Prøveudtagningsmetode
Sandsynlighedsprøve
Studiebefolkning
ICU patients requiring tracheal intubation
Beskrivelse
Inclusion Criteria:
- ICU patient requiring tracheal intubation
Exclusion Criteria:
- age < 18 years
- cardiac arrest
- acute respiratory failure requiring immediate high flow nasal cannula oxygen, defined as patient with SpO2 < 95% while under 15 L:min oxygen with a nonrebreathing facemask
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
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conventional high FiO2 bag reservoir facemask
this group of patients is intubated according to our current practice that requires the use of a high FiO2 nonrebreathing with bag reservoir facemask to ensure preoxygenation in patients requiring tracheal intubation.
a small nasal catheter is inserted just before laryngoscopy to ensure a low oxygen flow to allow oxygenation during laryngoscopy.
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high flow nasal cannula oxygen
we wish to change our standard practice of preoxygenation and expand our use of high flow nasal cannula oxygen therapy to the tracheal intubation setting.
Currently, used of high flow oxygen nasal cannula oxygen therapy to ensure oxygenation during intubation is limited to the patients already under high flow nasal cannula oxygen.
the change of practice consists in the systematic use of high flow nasal cannula oxygen therapy in all patients requiring tracheal intubation in the ICU.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
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lowest pulse oxymetry (SpO2) during intubation
Tidsramme: from beginning of laryngoscopy to completed intubation
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from beginning of laryngoscopy to completed intubation
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mean pulse oxymetry during intubation
Tidsramme: from beginning of laryngoscopy to completed intubation
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from beginning of laryngoscopy to completed intubation
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pulse oxymetry after preoxygenation
Tidsramme: 3min prexoxygenation
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3min prexoxygenation
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pulse oxymetry after intubation
Tidsramme: at connection of the patient to the ventilator
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at connection of the patient to the ventilator
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Sekundære resultatmål
Resultatmål |
Tidsramme |
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mean pulse oxymetry
Tidsramme: one, five and thirty minutes after intubation
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one, five and thirty minutes after intubation
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number of pulse oxymetry below 90%
Tidsramme: from laryngoscopy to 30 minutes once tracheal intubation completed
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from laryngoscopy to 30 minutes once tracheal intubation completed
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number of pulse oxymetry below 80%
Tidsramme: from laryngoscopy to 30 minutes once tracheal intubation completed
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from laryngoscopy to 30 minutes once tracheal intubation completed
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Andre resultatmål
Resultatmål |
Tidsramme |
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cardiac arrest
Tidsramme: during and immediately after procedure
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during and immediately after procedure
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hemodynamic instability defined as arterial systolic blood pressure below 80 mmHg
Tidsramme: during and immediately after procedure
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during and immediately after procedure
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Efterforskere
- Ledende efterforsker: Jean-Damien Ricard, MD, PhD, Hopital Louis Mourier, AP-HP, Colombes, France
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Sztrymf B, Messika J, Bertrand F, Hurel D, Leon R, Dreyfuss D, Ricard JD. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Intensive Care Med. 2011 Nov;37(11):1780-6. doi: 10.1007/s00134-011-2354-6. Epub 2011 Sep 27.
- Sztrymf B, Messika J, Mayot T, Lenglet H, Dreyfuss D, Ricard JD. Impact of high-flow nasal cannula oxygen therapy on intensive care unit patients with acute respiratory failure: a prospective observational study. J Crit Care. 2012 Jun;27(3):324.e9-13. doi: 10.1016/j.jcrc.2011.07.075. Epub 2011 Sep 29.
- Lenglet H, Sztrymf B, Leroy C, Brun P, Dreyfuss D, Ricard JD. Humidified high flow nasal oxygen during respiratory failure in the emergency department: feasibility and efficacy. Respir Care. 2012 Nov;57(11):1873-8. doi: 10.4187/respcare.01575. Epub 2012 Mar 13.
- Ricard JD. High flow nasal oxygen in acute respiratory failure. Minerva Anestesiol. 2012 Jul;78(7):836-41. Epub 2012 Apr 24.
- Miguel-Montanes R, Hajage D, Messika J, Bertrand F, Gaudry S, Rafat C, Labbe V, Dufour N, Jean-Baptiste S, Bedet A, Dreyfuss D, Ricard JD. Use of high-flow nasal cannula oxygen therapy to prevent desaturation during tracheal intubation of intensive care patients with mild-to-moderate hypoxemia. Crit Care Med. 2015 Mar;43(3):574-83. doi: 10.1097/CCM.0000000000000743.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. marts 2011
Primær færdiggørelse (Faktiske)
1. november 2012
Studieafslutning (Faktiske)
1. januar 2013
Datoer for studieregistrering
Først indsendt
1. oktober 2012
Først indsendt, der opfyldte QC-kriterier
3. oktober 2012
Først opslået (Skøn)
4. oktober 2012
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
12. august 2014
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
11. august 2014
Sidst verificeret
1. august 2014
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Andre undersøgelses-id-numre
- HLM_JDR1
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
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