Non-Invasive Mechanical Ventilation in Elderly Patients

NCT ID: NCT00600639

Last Updated: 2012-07-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

82 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-01-31

Study Completion Date

2007-12-31

Brief Summary

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The efficacy of NIMV to treat HARF has been widely demonstrated. However, in most of the studies performed in ICUs and in another facilities the mean age of the patients is usually less than 70 years.

A multicentric, randomized-controlled trial conduced in a group of "ELDERLY" patients with the mean age higher than 76 years, to compare the use of NIMV with Standard Medical Treatment (SMT) in the treatment of an episode of Acute Hypercapnic Respiratory Failure.

Detailed Description

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Non-invasive mechanical ventilation (NIMV) has been successfully used in Hypercapnic Acute Respiratory Failure (HARF) since endotracheal intubation (ETI) and invasive ventilation are associated to high morbidity and mortality rate.

because of the lack of beds in most Intensive Care Units (ICUs) and the high mortality and cost associated with the increased of age, the "Elderly" patients affected by ARF due to chronic diseases are not always considered for ETI.

The efficacy of NIMV to treat HARF has been widely demonstrated. However, in most of the studies performed in ICUs and in another facilities the mean age of the patients is usually less than 70 years (see tab1).

Authors MEAN AGE

(yrs) TYPE of STUDY

Bott \<80 COPD NIV vs Medical Therapy

Brochard71±9 COPD NIV vs Medical Therapy

Kramer 66±7 COPD NIV vs Medical Therapy

Andeev 63±4 COPD NIV vs Medical Therapy

Barbe 70±2 COPD NIV vs Medical Therapy

Bardi 68±8 COPD NIV vs Medical Therapy

Plant 69±8 COPD NIV vs Medical Therapy

Thys 71±8 COPD NIV vs sham NIV

Nava 68±8 COPD NIV in weaning

Girault 63±14 NIV in weaning

Ferrer 70±7 NIV in weaning

Hill 71±3 COPD PAV vs PSV

Confalonieri 66±14 PNEUMONIA NIV vs Medical Therapy

Martin 64±17 Miscellaneous NIV vs Medical Therapy

Conti 72±7 COPD NIV vs EI

A multicentric, randomized-controlled trial conducted in a group of "ELDERLY" patients with the mean age higher than 76 years, to compare the use of NIMV with Standard Medical Treatment (SMT) in the treatment of an episode of Acute Hypercapnic Respiratory Failure.

Conditions

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Acute Respiratory Failure

Keywords

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old patients NIV Intubation COPD

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

non-invasive ventilation with BiPAP Vision or another ICU ventilator with NIV option

Group Type EXPERIMENTAL

Non-invasive mechanical ventilation using a BiPAP Vision or any other ICU ventilators with NIV option

Intervention Type DEVICE

A mode of ventilation that does not require the insertion of the endotracheal tube, since the support is delivered throgh a full face or nasal mask

standard medical therapy plus oxygen that includes salbutamol, prednisolone and antibiotics as needed

Intervention Type DRUG

Standard medical therapy includes drugs like beta2-agonists, steroids, anthicolinergic agents- antibuiotics as needed

2

standard therapy + oxygen

Group Type ACTIVE_COMPARATOR

standard medical therapy that includes salbutamol, prednisolone and antibiotics as needed

Intervention Type DRUG

oxygen plus medical therapy for ARF

Interventions

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Non-invasive mechanical ventilation using a BiPAP Vision or any other ICU ventilators with NIV option

A mode of ventilation that does not require the insertion of the endotracheal tube, since the support is delivered throgh a full face or nasal mask

Intervention Type DEVICE

standard medical therapy plus oxygen that includes salbutamol, prednisolone and antibiotics as needed

Standard medical therapy includes drugs like beta2-agonists, steroids, anthicolinergic agents- antibuiotics as needed

Intervention Type DRUG

standard medical therapy that includes salbutamol, prednisolone and antibiotics as needed

oxygen plus medical therapy for ARF

Intervention Type DRUG

Other Intervention Names

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BiPAP Vision or any other ICU ventilators with NIV option

Eligibility Criteria

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Inclusion Criteria

* Age higher 75 years old
* Hypercapnic acute respiratory failure (PaCO2 greater 50 mmHg and pH lower than 7.35)
* Respiratory rate (RR) higher 25 bpm after 12 hours of standard medical therapy.

Exclusion Criteria

* Respiratory failure due to pulmonary oedema
* Kelly's score equal or higher than 4
* Cardio-respiratory arrest
* Systolic arterial blood pressure greater than 90 mmHg or severe arrhythmia
* Recent facial, oesophageal and gastric surgery
Minimum Eligible Age

76 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Villa Gaiato, Modena

UNKNOWN

Sponsor Role collaborator

Ospedale Regionale di Locarno

OTHER

Sponsor Role collaborator

IRCCS Azienda Ospedaliero-Universitaria di Bologna

OTHER

Sponsor Role lead

Principal Investigators

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Stefano Nava

Role: PRINCIPAL_INVESTIGATOR

Fondazione Salvatore Maugeri

Locations

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Istituto Scientifico di Pavia Fondazione Salvatore Maugeri

Pavia, Pavia, Italy

Site Status

Countries

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Italy

Other Identifiers

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2004-78

Identifier Type: -

Identifier Source: secondary_id

FSM2004-78

Identifier Type: -

Identifier Source: org_study_id