Hypercapnic Respiratory Failure Clinical Trial
Official title:
High Flow Nasal Oxygen in Addition to Non Invasive Ventilation During Hypercapnic Respiratory Failure
this study evaluates high flow oxygen therapy in addition to non invasive ventilation (NIV) to treat hypercapnic respiratory failure. Between sessions of NIV, half of participants will have high flow nasal cannula while the others will have standard low flow oxygen therapy.
High Flow Nasal Cannula (HFNC) is a new way of oxygen therapy that has gained interest in the
management of patients with acute respiratory failure. It allows reaching a high flow air up
to 60 liters / min via a nasal cannula with a humidification and warming of the air
administered. It has a number of physiological effects such as wash out of anatomical dead
space, generation of a small PEEP and high inspired fraction of oxygen which enhances
compliance and reduces inspiratory efforts.
NIV is the corner stone in the treatment of severe COPD exacerbation. Nevertheless, prolonged
application of the facial mask expose to local complications and intolerance which can be a
cause of failure, so reducing the duration of exposure to this procedure is important.
The role of HFNC in supplementing NIV effect during hypercapnic respiratory failure has not
been assessed. Much of the data available on HFNC are about hypoxemic respiratory failure.
Because of its physiological effects, it can be hypothesized that HFNC in addition to NIV can
shorten its duration by facilitating carbon dioxide clearance.
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