Pulmonary Disease, Chronic Obstructive Clinical Trial
Official title:
Extracorporeal CO2 Removal in Hypercapnic Patients Who Failed Noninvasive Ventilation and Refuse Endotracheal Intubation: a Case Series
Noninvasive ventilation represents the standard of care for patients with exacerbation of chronic obstructive pulmonary disease. However, NIV fails in almost 30% of the most severe forms of acute hypercapnic respiratory failure and patients must undergo endotracheal intubation and invasive ventilation to restore adequate gas exchange. Under these circumstances, patients may express a clear intention not to be intubated.The aim of this study is to retrospectively assess efficacy and safety of noninvasive ventilation- plus-extracorporeal Co2 removal in patients who fail NIV and refuse endotracheal intubation.
During a period of two years (from January 2013 to July 2015) 35 patients with acute
hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary
disease, refused endotracheal intubation after failing NIV and were treated with
extracorporeal Co2 removal plus NIV as last resort therapy.
The collected data of these patients will be retrospectively matched with data obtained from
35 historical controls who received conventional treatment with endotracheal intubation. The
study will retrospectively compare intubation rate, acid base homeostasis, norepinephrine
requirements (in the patients who due to clinical conditions were under norepinephrine
before starting extracorporeal Co2 removal ) and coagulation parameters.
;
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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