Hypoxaemic patients with exacerbations of chronic obstructive pulmonary disease (COPD) are at some risk of carbon dioxide (CO2) retention during oxygen therapy. Main mechanism of CO2 retention is believed to be reversal of preexisting regional hypoxic pulmonary vasoconstriction, resulting in a greater dead space. Risk of CO2 retention during mechanical ventilation remains controversial. Thus recent study suggested limited risk of CO2 retention with controlled oxygen supplementation during mechanical ventilation. Conversely, controlled oxygen supplementation might decrease dyspnea and respiratory workload, increase comfort and improve both urinary output and renal function.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
1
Maintenance of an oxygen setting allowing normal oxygen saturation during non-invasive mechanical ventilation (SpO2 targeted 96-98%)
Maintenance of an oxygen setting allowing mild hypoxemia during non-invasive mechanical ventilation (SpO2 targeted 88-92%)
CHU de CLERMONT-FERRAND
Clermont-Ferrand, France
CHu de GRENOBLE
Grenoble, France
CHU de la Pitié-Salpêtrière
Paris, France
CHU de SAINT-ETIENNE
Saint-Etienne, France
urinary output (ml)
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours
Changes in CO2 levels
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72hours
respiratory workload during non-invasive mechanical ventilation (occlusion pressure (cm H2O) to 100 ms after the onset of inspiration)
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72 hours
Serum creatinine
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72hours
Renal resistive index
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72hours
Pulmonary arterial pressure
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72hours
Semiquantitative assessment of dyspnea (visual likert scale)
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72hours
Semiquantitative assessment of comfort (visual likert scale)
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72hours
Fluid balance
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72hours
SOFA (Sequential Organ Failure Assessment) score
First 24 hours of non-invasive mechanical ventilation
Time frame: 24 hours, 48 hours, 72hours
Mortality
First 24 hours of non-invasive mechanical ventilation
Time frame: up to day 28
Number of patients requiring mechanical ventilation
Evaluation until 28 days with an evaluation at intensive care unit discharge, and at hospital discharge
Time frame: up to day 28
days alive without mechanical ventilation
Evaluation up to 28 days with an evaluation at intensive care unit discharge, and at hospital discharge
Time frame: up to day 28
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