Study of High Flow Nasal Cannula Oxygen for Bronchoscopy With Bronchoalveolar Lavage in ICU Patients

Hôpital Louis Mourier30 enrolled

Overview

Bronchoscopy with bronchoalveolar lavage (BAL) is at risk for worsening hypoxemia in patients with acute respiratory failure (ARF). High-flow nasal cannula oxygen (HFNC) improves hypoxemia in ARF patients . We investigated its efficacy and tolerance in intensive care unit patients admitted for ARF requiring BAL.

Prospective, observational, multicenter study in ARF patients (minimal pulse oximetry -SpO2- of 92% with an minimal oxygen flow of 6 L/min , respiratory rate \> 25/min (20/min if use of accessory respiratory muscles) with a compatible etiology. Primary outcome measure is increase in ventilatory support (non-invasive positive pressure ventilation (NPPV) or endotracheal intubation (ETI)) within the first 24h following BAL.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Respiratory Insufficiency

Interventions

Adult ARF ICU patients needing BAL with HFNCPROCEDURE

bronchoalveolar lavage is performed in spontaneously breathing patients under high flow nasal cannula oxygen

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * presence of acute respiratory failure: defined as respiratory rate greater than 25/min, (or greater than 20/min if use of accessory respiratory muscles was present), in patients requiring oxygen greater than or equal to 6 L/min to obtain a pulse oximetry greater than 92% * need for bronchoalveolar lavage (decision to perform BAL was left at the physician's discretion) Exclusion Criteria: * at least one contraindication to the bronchoscopy with BAL: acute coronary syndrome within 6 weeks; neurologic failure; thrombocytopenia less than 30 000/mm3; respiratory acidosis with a pH lower than 7.30 or hypercapnia higher than 60 mmHg; pneumothorax undrained.

Locations (4)

Hopital Antoine Béclère

Clamart, France

Louis Mourier Hospital

Colombes, France

Hopital Henri Mondor

Créteil, France

Hôpital Tenon

Paris, France

Outcomes

Primary Outcomes

increase in ventilatory support

increase in ventilatory support (non-invasive positive pressure ventilation (NPPV) or endotracheal intubation (ETI)) within the first 24h following BAL

Time frame: 24h

Secondary Outcomes

Immediate tolerance of bronchoscopy and BAL

Vital signs, dyspnea score

Time frame: 12h

Operator's satisfaction

Physician performing the BAL procedure rated their comfort with HFNC from 0 to 10

Time frame: 15min

Data from ClinicalTrials.gov

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