Acute Respiratory Failure Clinical Trial
Official title:
Multicenter National Randomized Controlled Open Label Study Assessing Interest of Non Invasive Ventilation in out-of Hospital Setting During Acute Respiratory Failure in Chronic Obstructive Pulmonary Disease Patients. VeNIS BPCO
Goal of the study: To show that prehospital NPPV use for COPD decompensation, as compared to
only standard medical treatment, might enable a decrease in intubation rate.
Primary end point: the rate of endotracheal intubation in the first three hours after
randomization.
Secondary en points: rate of endotracheal intubation after third hour, rate of prehospital
and ICU mortality, ICU days, effects on clinical parameters (respiratory rate, SpO2, heart
rate, arterial blood pressure, consciousness) and arterial blood gases (pH, PaCO2, PaO2), 30
days mortality, delays between first medical contact and in-hospital admission, relation
between initial pH level and endotracheal intubation.
Inclusion criteria: Adult patients (>18 years), with GCS≥10, known or suspected COPD and
presenting acute respiratory decompensation with respiratory acidosis.
Exclusion criteria: Cardiac or respiratory arrest, upper gastro intestinal tract
haemorrhage, shock, serious ventricular arrhythmia, severe sepsis, multiple organ failure,
serious cranial-facial trauma, upper airways obstruction, undrained pneumothorax,
uncooperative-agitated patients refusing the technique, respiratory distress with bradypnoea
< 12/min, pauses gasps repeated bradycardia, intractable vomiting, acute traumatic
tetraplegia, persistant hemodynamic instability with PAS<90mmHg, ensuitable environment.
Randomization: Assignment to NPPV group or standard therapy group will be performed at the
time of arrival of the SAMU team to the patient, by calling a physician located at the
calldispatch center who will connect to the web site of the clinical research unit from
Bordeaux university hospital.
Period of study: 25 months (24 months for patients inclusion and 1 month for follow-up).
Number of patients: 199 patients in each group i.e 398 patients (significance level of 5%,
power of 80%; 50% expected decrease of intubation rate, i.e. from 20 to 10%).
Main investigator: Dr Pierre-Arnaud Fort, MD, Pôle Urgences-SAMU47-Réanimation, Centre
Hospitalier Saint-Esprit - Agen.
Participating centers : 20 SAMU-SMUR corresponding to 19 departments in France.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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