Acute Respiratory Distress Syndrome Clinical Trial
Official title:
A Multicentre, Randomized, Clinical Trial of Respiratory Support With Standard Low Flow Oxygen Therapy, Continuous Positive Airway Pressure, and High-flow Oxygen Therapy in Adults With Acute Hypoxemic Respiratory Failure in Uganda
The dearth of Intensive care units in low resource settings portends for poor outcomes amongst patients with acute hypoxemic respiratory failure (AHRF) . To our knowledge, the effect of CPAP and HFNC on major outcomes has not been assessed in adults with AHRF in resource-limited settings. The aim of this prospective, multicenter, randomized, controlled, trial is to determine whether High-flow oxygen through a nasal cannula (HFNC) or Continuous positive airway pressure (CPAP) system can reduce mortality among patients with acute hypoxemic respiratory failure (AHRF) in a limited resource setting as compared with standard low flow oxygen therapy?
The care for the critically ill patient typically takes place in the intensive care unit (ICU). ICU care is quite expensive, even in resource rich countries. The most common reason for ICU admission globally is respiratory support for acute hypoxemic respiratory failure (AHRF). In patients with AHRF, the need for invasive mechanical ventilation is associated with high mortality, especially in low income countries (LICs), given the scarce availability of invasive mechanical ventilation. Some studies suggest that administration of ventilatory support through a mask may be effective in resource-limited settings. However, there is no clinical study data in adults to support this evidence. Human and material constraints are major barriers for the care of critically-ill patients in resource limited settings , advocating the need for a frugal approach. Furthermore, the scarcity of intensive care unit care in LICs contributes to a high mortality among acutely ill patients. The current corona virus pandemic has further highlighted the need for frugal acute care interventions in LICs. Continuous positive airway pressure (CPAP) is a simple to use and affordable technique for noninvasive ventilatory support. High-flow oxygen through a nasal cannula (HFNC) may also offer an alternative in patients with hypoxemia. The high flow rates may also decrease physiological dead space by flushing expired carbon dioxide from the upper airway, a process that potentially explains the observed decrease in the work of breathing. Frugal CPAP or HFNC , as compared with standard oxygen therapy, could reduce the mortality among adults presenting with AHRF in a resource-limited setting. ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT04384445 -
Zofin (Organicell Flow) for Patients With COVID-19
|
Phase 1/Phase 2 | |
Recruiting |
NCT05535543 -
Change in the Phase III Slope of the Volumetric Capnography by Prone Positioning in Acute Respiratory Distress Syndrome
|
||
Completed |
NCT04695392 -
Restore Resilience in Critically Ill Children
|
N/A | |
Terminated |
NCT04972318 -
Two Different Ventilatory Strategies in Acute Respiratory Distress Syndrome Due to Community-acquired Pneumonia
|
N/A | |
Completed |
NCT04534569 -
Expert Panel Statement for the Respiratory Management of COVID-19 Related Acute Respiratory Failure (C-ARF)
|
||
Completed |
NCT04078984 -
Driving Pressure as a Predictor of Mechanical Ventilation Weaning Time on Post-ARDS Patients in Pressure Support Ventilation.
|
||
Completed |
NCT04451291 -
Study of Decidual Stromal Cells to Treat COVID-19 Respiratory Failure
|
N/A | |
Not yet recruiting |
NCT06254313 -
The Role of Cxcr4Hi neutrOPhils in InflueNza
|
||
Not yet recruiting |
NCT04798716 -
The Use of Exosomes for the Treatment of Acute Respiratory Distress Syndrome or Novel Coronavirus Pneumonia Caused by COVID-19
|
Phase 1/Phase 2 | |
Withdrawn |
NCT04909879 -
Study of Allogeneic Adipose-Derived Mesenchymal Stem Cells for Non-COVID-19 Acute Respiratory Distress Syndrome
|
Phase 2 | |
Not yet recruiting |
NCT02881385 -
Effects on Respiratory Patterns and Patient-ventilator Synchrony Using Pressure Support Ventilation
|
N/A | |
Terminated |
NCT02867228 -
Noninvasive Estimation of Work of Breathing
|
N/A | |
Completed |
NCT02545621 -
A Role for RAGE/TXNIP/Inflammasome Axis in Alveolar Macrophage Activation During ARDS (RIAMA): a Proof-of-concept Clinical Study
|
||
Withdrawn |
NCT02253667 -
Palliative Use of High-flow Oxygen Nasal Cannula in End-of-life Lung Disease Patients
|
N/A | |
Completed |
NCT02232841 -
Electrical Impedance Imaging of Patients on Mechanical Ventilation
|
N/A | |
Withdrawn |
NCT01927237 -
Pulmonary Vascular Effects of Respiratory Rate & Carbon Dioxide
|
N/A | |
Completed |
NCT01504893 -
Very Low Tidal Volume vs Conventional Ventilatory Strategy for One-lung Ventilation in Thoracic Anesthesia
|
N/A | |
Completed |
NCT02889770 -
Dead Space Monitoring With Volumetric Capnography in ARDS Patients
|
N/A | |
Completed |
NCT02814994 -
Respiratory System Compliance Guided VT in Moderate to Severe ARDS Patients
|
N/A | |
Completed |
NCT01680783 -
Non-Invasive Ventilation Via a Helmet Device for Patients Respiratory Failure
|
N/A |