Respiratory Support in Severe Chronic Obstructive Pulmonary Disease Exacerbation
2020年1月13日 更新者：Qingyuan Zhan、China-Japan Friendship Hospital
Comparison of High Flow Nasal Cannula, Noninvasive Positive Ventilation (NPPV) and Invasive Positive Ventilation (IPPV) in Severe Chronic Obstructive Pulmonary Disease Exacerbation (AECOPD)
Preliminary studies have shown that NPPV can avoid tracheal intubation in 40% to 60% patients who have severe exacerbation of COPD.
Recently, large-scale comparative effectiveness research (CER) also found that compared with invasive ventilation, NPPV can reduce mortality rates.
But there's no high-quality clinical studies which can confirm this.
Therefore, investigators believe that NPPV can avoid intubation in patients with severe exacerbation of COPD in ICU with perfect monitoring conditions and reasonable human resource allocation, in order to reduce IMV-related complications and improve patients' outcomes.
研究概览
地位
未知
条件
详细说明
In part of the patients who were AECOPD with pH <7.25 , preliminary studies have shown that NPPV can avoid tracheal intubation in 40% to 60% patients, and also reduce the incidence of VAP.
Recently, large-scale comparative effectiveness research (CER) also found that compared with invasive ventilation, NPPV can reduce mortality rates.
At present, there's no high-quality clinical studies which can confirm this, and clinical guidelines do not have a recommendation on the use of NPPV in these patients.
Therefore, investigators believe that NPPV can avoid intubation in patients with severe exacerbation of COPD in ICU with perfect monitoring conditions and reasonable human resource allocation, as well as the progress of medical technology in NPPV in recent years, in order to reduce IMV-related complications and improve patients' outcomes.
研究类型
观察性的
注册 (预期的)
208
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
Beijing
-
Beijing、Beijing、中国、100028
- 招聘中
- China-Japan Friendship Hospital
-
-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 85年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
取样方法
概率样本
研究人群
All patients with acute exacerbation of chronic obstructive pulmonary disease in medical ICU.
描述
Inclusion Criteria:
- AECOPD;
Exclusion Criteria:
- refuse to engage in the study;
- have been included in other study.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
|---|
|
Noninvasive ventilation
Noninvasive positive pressure ventilation is achieved by Philips Respironics V60/Vision ventilator.
Choose bilevel positive airway pressure mode, and adjust the fraction of inspire oxygen(FiO2) or oxygen flow rate to maintain patient's oxygen saturation(SpO2) between 88% to 92%.
Parameter adjustment and weaning of NPPV follow the protocols used before.
|
|
Invasive ventilation
Intubated immediately and connected to the ventilator.
Parameter adjustment and weaning of IPPV follow the protocols used before.
|
|
High flow nasal cannula
High flow nasal cannula of different models (large, medium and small) are selected depending on the size and comfort of the patient's nostrils.
Adjusting the oxygen flow rate (O2 Flow) maintains the patient's SpO2 88% to 92%.
The flow was initially adjusted to 25 L/min and the flow was gradually adjusted to the patient's maximum tolerance.
The inspiratory gas temperature (31 to 37 °C) was set to the patient's maximum tolerance level.
If the patient's condition deteriorates and the tracheal intubation standard is met , the patient is recommended to undergo invasive ventilation treatment, but the choice of the final respiratory support method should be decided by the attending physician, patient and family.
|
研究衡量的是什么？
主要结果指标
结果测量 |
大体时间 |
|---|---|
|
The incidence of ventilator-associated pneumonia (VAP)
大体时间：90days
|
90days
|
|
The all cause mortality of ICU and hospitalization
大体时间：90 days
|
90 days
|
次要结果测量
结果测量 |
大体时间 |
|---|---|
|
The length of stay of ICU and hospitalization
大体时间：90 days
|
90 days
|
|
The length of stay of mechanical ventilation
大体时间：90 days
|
90 days
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2017年1月1日
初级完成 (预期的)
2020年12月1日
研究完成 (预期的)
2020年12月1日
研究注册日期
首次提交
2017年1月9日
首先提交符合 QC 标准的
2017年1月11日
首次发布 (估计)
2017年1月13日
研究记录更新
最后更新发布 (实际的)
2020年1月18日
上次提交的符合 QC 标准的更新
2020年1月13日
最后验证
2020年1月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.