the study compares two non-invasive respiratory support modalities ie CPAP and High Flow nasal cannula oxygen for the treatment of severe hypoxemic respiratory failure attributed to Community acquired Pneumonia.
CPAP and High Flow nasal cannula oxygen are two established modalities for non-invasive respiratory support . In COVID pandemic era both CPAP and HFNO were widely used in the ward for the treatment of COVID-19 induced acute hypoxemic respiratory failure in order to prevent progression to intubation. Head to head comparison between the two modalities mentioned for the treatment of severe hypoxemic respiratory failure is not available neither in COVID pneumonia or Community acquired pneumonia (CAP).
Study Type
OBSERVATIONAL
Enrollment
100
CPAP will be delivered with a CPAP valve with venturi flow system with full-face mask. Treatment will start with CPAP set at 10cmH2O and FiO2 60% to target a SpO2 ≥90% or PO2 ≥60mmHg and then adjusted according to SpO2, respiratory distress and clinical tolerance
HFNO will be applied initially at maximal settings: 100% FiO2, flow rate 60 L/min and temperature 37C . Within 1 to 2 h, the HFNO settings should be titrated based on patients respiratory rate (\<25-30 per minute), SpO2 (92-96%) and comfort
Evaggelismos Hospital
Athens, Attica, Greece
RECRUITINGUniversity General Hospital of Larissa
Larissa, Thesaly, Greece
RECRUITINGdays free from ventilatory support
days without support with either mechanical ventilation, HFNO, CPAP
Time frame: 28 days
treatment failure defined
no of patients that needed intubation and invasive mechanical ventilation or died
Time frame: 28 days
intubation rate
Time frame: 28 days
hospital mortality
Time frame: 28 days
days under non-invasive respiratory support
days without support with HFNO or CPAP
Time frame: 28 days
hospital length of stay
Time frame: 28 days
Partial pressure of oxygen PaO2 change at 2h, 12h and 24h
Time frame: 28 days
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