Hematologic Malignancy Clinical Trial
Official title:
Effectiveness of High Flow Oxygen Therapy in Patients With Hematologic Malignancy Acute Hypoxemic Respiratory Failure
Effectiveness of high flow oxygen therapy in patients with hematologic malignancy acute hypoxemic respiratory failure
Acute respiratory failure (ARF) is the leading reason for ICU admission in immunocompromised
patients. Usual oxygen therapy involves administering low-to-medium oxygen flows through a
nasal cannula or mask to achieve SpO2≥95%.
High-flow nasal oxygen [HFNO] therapy is a focus of growing attention as an alternative to
standard oxygen therapy. By providing warmed and humidified gas, HFNO allows the delivery of
higher flow rates [of up to 60 L/min] via nasal cannula devices, with fraction of inspired
oxygen (FiO2) values of nearly 100%. Physiological benefits of HFNO consist of higher and
constant FiO2 values, decreased work of breathing, nasopharyngeal washout leading to improved
breathing-effort efficiency, and higher positive airway pressures associated with better lung
recruitment.
Clinical consequences of these physiological benefits include alleviation of dyspnea and
discomfort, decreases in tachypnea and signs of respiratory distress, a diminished need for
intubation in patients with severe hypoxemia, and decreased mortality in unselected patients
with acute hypoxemic respiratory failure However, although preliminary data establish the
feasibility and safety of this technique, HFNO has never been properly evaluated in
immunocompromised patients.
Thus, this project aims at demonstrating that HFNO is superior to low/medium-flow (standard)
oxygen, minimizing the need for endotracheal intubation
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