Comparison of High-flow Oxygen vs. BiPAP in Type II (Hypercapnic) Respiratory Failure

Hôpital de Verdun324 enrolled

Overview

A retrospective cohort study of all patients treated for type II (hypercapnic) respiratory failure with either High-Flow Oxygen Therapy or Non-Invasive Ventilation in a general adult hospital.

We will compare various clinically relevant outcomes in patients treated for type II (hypercapnic) acute respiratory failure (ARF) with either High-Flow Nasal Cannula (HFNC) or Non-Invasive Ventilation (NIV) in a general adult hospital. All patients treated with HFNC were treated with an Optiflow device (Fisher\&Paykel). Various Bilevel positive airway pressure (BiPAP) devices were used during the study period. All ventilatory parameters were set according to the treating physicians' preferences.

Study Type

OBSERVATIONAL

Enrollment

324

Conditions

Respiratory Failure Respiratory Insufficiency Respiratory Tract Diseases COPD COPD Exacerbation Pneumonia Chronic Obstructive Pulmonary Disease

Interventions

Non-Invasive VentilationDEVICE

Treatment with Non-Invasive Ventilation by BiPAP. Different BiPAP models are in use. Ventilation parameters set at the discretion of the treating physician.

High-Flow Nasal CannulaDEVICE

Treatment with a High-Flow Nasal Cannula. The Optiflow device by Fisher\&Paykel used in all cases. Flow and fraction of inspired oxygen (FiO2) parameters at the discretion of the treating physician.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All patients treated with respiratory failure not responding to conventional supplemental oxygen therapy * Blood venous gas showing partial pressure of carbon dioxide\>50 mmHg before beginning therapy with either NIV or HFNC Exclusion Criteria: * Lack of records of the primary outcome * End-of-life care * Lack of gas before the beginning of NIV or HFNC

Locations (1)

Hôpital de Verdun

Montreal, Quebec, Canada

Outcomes

Primary Outcomes

Failure of initial treatment (combined outcome)

Combined outcome of death or intubation or transition to another treatment modality or unplanned resumption of respiratory support

Time frame: 48 hours post intervention

Death at 48h

Mortality in the 48h following the initial intervention

Time frame: 48 hours post intervention

Secondary Outcomes

Mortality at 7d

Incidence of death in the 7 days after intervention

Time frame: 7 days post intervention

Incidence of endotracheal intubation

The incidence of intubation

Time frame: For the whole length of hospital stay, up to a maximum of one year.

Length of stay

Duration of stay in the hospital, in days

Time frame: For the whole length of hospital stay, up to a maximum of one year.

Duration of endotracheal intubation

Duration (in hours) of the first episode of endotracheal intubation, immediately following the failed intervention

Time frame: For the whole length of hospital stay, up to a maximum of one year.

Incidence of intervention change

The incidence of patients who switch from Non-Invasive Ventilation to High-Flow Oxygen, and vice versa, due to treatment failure

Time frame: For the whole length of hospital stay, up to a maximum of one year.

Data from ClinicalTrials.gov

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