- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT01699880
Efficacy of High Flow Nasal Cannula Oxygen to Reduce Desaturation During Tracheal Intubation (HAPI)
11 augusti 2014 uppdaterad av: 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).
Studieöversikt
Status
Avslutad
Detaljerad beskrivning
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.
Studietyp
Observationell
Inskrivning (Faktisk)
101
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
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Colombes, Frankrike, 92701
- Medico-surgical ICU
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Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
18 år och äldre (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Testmetod
Sannolikhetsprov
Studera befolkning
ICU patients requiring tracheal intubation
Beskrivning
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
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
Kohorter och interventioner
Grupp / Kohort |
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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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Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
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lowest pulse oxymetry (SpO2) during intubation
Tidsram: 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
Tidsram: 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
Tidsram: 3min prexoxygenation
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3min prexoxygenation
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pulse oxymetry after intubation
Tidsram: at connection of the patient to the ventilator
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at connection of the patient to the ventilator
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Sekundära resultatmått
Resultatmått |
Tidsram |
---|---|
mean pulse oxymetry
Tidsram: 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%
Tidsram: 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%
Tidsram: 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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Andra resultatmått
Resultatmått |
Tidsram |
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cardiac arrest
Tidsram: 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
Tidsram: during and immediately after procedure
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during and immediately after procedure
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Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Sponsor
Utredare
- Huvudutredare: Jean-Damien Ricard, MD, PhD, Hopital Louis Mourier, AP-HP, Colombes, France
Publikationer och användbara länkar
Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.
Allmänna 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.
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart
1 mars 2011
Primärt slutförande (Faktisk)
1 november 2012
Avslutad studie (Faktisk)
1 januari 2013
Studieregistreringsdatum
Först inskickad
1 oktober 2012
Först inskickad som uppfyllde QC-kriterierna
3 oktober 2012
Första postat (Uppskatta)
4 oktober 2012
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
12 augusti 2014
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
11 augusti 2014
Senast verifierad
1 augusti 2014
Mer information
Termer relaterade till denna studie
Nyckelord
Andra studie-ID-nummer
- HLM_JDR1
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .
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