Cancer Clinical Trial
Official title:
Evaluation of Oxygenation Methods and Non-invasive Ventilatory Support in Patients With Acute Respiratory Failure for Whom a Do-not Intubate Order Was Taken: Prospective Observational Study
ICU care of patients considered "palliative" but without contraindications to admission to intensive care, for whom a do-not intubate order decision was made upon admission represents a particular target for non-invasive oxygenation techniques. The benefits of non invasive ventilation (NIV) in this population are debated especially in cancer patients. The more recently used nasal humidified high flux canula oxygenation (HFNC) therapy may have benefits over NIV in these patients. It is supposed to have better tolerance and could allow better compliance and thus higher efficiency. These potential benefits are major for such a population for which tolerance and symptomatic relief are priority goals
Observational prospective multicenter study Primary outcome: To analyze the efficacy and
tolerance of NIV and HFNC in patients admitted to intensive care unit, or intermediate catre
unit for acute respiratory insufficiency for whom a a do-not intubate order decision was
taken upon admission or after extubation if the patient initially received mechanical
ventilation.
Secondary outcomes: To analyze the efficacy and tolerance of NIV and HFNC according to the
following reason for ICU admission: chronic obstructive pneumopathy decompensated COPD,
severe heart failure, evolutive cancer or hematologic malignancy; to analyze tolerance and
acceptability of different techniques; to analyze the duration of the oxygenation methods
use; to analyze the modalities of eventual withdrawing life support therapies and the
associated sedative and opioid treatments; to analyze the satisfaction for the use of the non
invasive technique by the relatives and the caregivers; to analyze mortality at D28 and D90
and quality of life at 3 and 6 months in surviving patients
;
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