The purpose of the study is to determine whether SBCT is a useful tool for diagnosing the main form of failure respiratory acute and to define the SBCT limit associated with insufficiency respiratory in this population, the requirement for NIV or invasive ventilation. Furthermore, the correlation with the most common scores and indices used in the emergency room will be studied, such as: HACOR, MEW, REMS SCORE, ROS, CURB-65, qSOFA, SEVERITY INDEX OF PNEUMONIA, GWTG HF, LUNG ULTRASOUND SCORE, SINGLE BREATH COUNT
Single breath counting test (SBCT) is the measurement of how far an individual can count in a normal speaking voice after a maximal effort inspiration. Previous work has demonstrated that SBCT has good correlation with the gold standard measures of pulmonary function test, peak expiratory flow rate and forced expiratory volume in the first second. The easy of the SBCT makes this test appealing for rapid assessment of respiratory status overall in patients admitted for acute respiratory failure and we hypothesized that it will be valuable, replicable and fast tools for bedside assessment of respiratory function in Emergency Department. The purpose of the study is to determine whether SBCT is a useful tool for diagnosis of the major form of acute respiratory failure and to define the cut-off limit of SBCT associated to respiratory failure in this population, requirement of NIV or invasive ventilation. Moreover, it will be studied the correlation with the most common scores and indexes used in emergency department like: HACOR, MEW, REMS SCORE, ROS, CURB-65, qSOFA, PNEUMONIA SEVERITY INDEX, GWTG-HF, LUNG ULTRASOUND SCORE, SINGLE BREATH COUNTING TEST
Study Type
OBSERVATIONAL
Enrollment
600
Patients who have SpO2 \< 92% on room air will undergo oxygen therapy (nasal cannula or Venturi-mask).
Patients with P/F \< 250 or Ph \< 7,35 with PCO2 \> 50 mmHg will undergo Non-Invasive Ventilation (NIV) (high flow nasal cannula or CPAP).
Patients with P/F \< 150 associated to dyspnea at rest (moderate to severe, shortness of breath and/ or tachypnea (\>24 breaths/min) despite NIV for at least 2 hours or patients with Ph \< 7,2 with PCO2 \> 60 mmHg despite NIV for at least 2 hours will undergo invasive ventilation (intubation).
Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo
Alessandria, Piedmont, Italy
RECRUITINGSingle Breath Counting Test (SBCT)
Determine if SBCT is a useful, fast and reproducible tool for assessing respiratory failure and its severity in the Emergency Department.
Time frame: Change from Baseline at 3 hours
SBCT as predictor NIRS
Define if Single Breath Counting Test (SBCT) could be a predictor of Non-Invasive Respiratory Strategies (NIRS)
Time frame: Change from Baseline at 3 hours
Correlation with the main critical illness scores
Define the correlation of SBCT with the main critical illness scores
Time frame: Change from Baseline at 3 hours
Correlation with the main serum markers
Define the correlation of SBCT with the main serum markers corresponding to the underlying respiratory failure disorder
Time frame: Change from Baseline at 3 hours
Correlation with imaging
Define the correlation of SBCT with radiographic (infiltrated) and ultrasound imaging
Time frame: Change from Baseline at 3 hours
Cut-off limit of SBCT
Define the cut-off limit, the sensitivity and the specificity of SBCT associated with respiratory failure
Time frame: Change from Baseline at 3 hours
Cut-off limit to initiate appropriate respiratory support
Define the cut-off limit to initiate appropriate respiratory support
Time frame: Change from Baseline at 3 hours
Correlation with Emergency Room Mortality
Define the correlation of SBCT with Emergency Room Mortality
Time frame: Change from Baseline at 3 hours
Correlation between pulmonary and extrapulmonary causes
Correlation between pulmonary and extrapulmonary causes
Time frame: Change from Baseline at 3 hours
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