Helmet Continuous Positive Airway Pressure Versus Oxygen Venturi in Acute Respiratory Failure in CAP: CAPOVeRSO

NCT ID: NCT00603564

Last Updated: 2009-12-02

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

47 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-01-31

Study Completion Date

2008-07-31

Brief Summary

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The purpose of this study is to compare the efficacy of CPAP application by a helmet and O2 administration by a Venturi mask in terms of gas exchanges improvement in patients with acute respiratory failure due to community-acquired pneumonia.

Detailed Description

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Community-acquired pneumonia (CAP) is one of the commonest causes of hospitalised acute respiratory failure with a mortality rate up t 30%.

Continuous Positive Airway Pressure (CPAP) has ben recently proved to be effective. To date, however, no prospective randomised study has been published on the comparison between CPAP and O2 administration via a Venturi mask for the treatment of acute respiratory failure in immunocompetent patients with community-acquired pneumonia.

Therefore, the aim of this study is to compare the efficacy of CPAP delivered by a helmet and O2 administration via a Venturi mask in terms of gas exchanges improvement in early acute respiratory failure (PaO2/FiO2 between 210 and 285)due to community-acquired pneumonia.

A Steering Committee composed by the principal investigators will request an interim analysis at 20% enrolment in order to monitor the criteria for equipoise of the two treatments.

Conditions

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Pneumonia Community-Acquired Infections Respiratory Insufficiency Acute Lung Injury

Keywords

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CPAP community-acquired pneumonia acute respiratory failure hypoxemia Continuous Positive Airway Pressure

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

CPAP delivered by a helmet

Group Type ACTIVE_COMPARATOR

Castar Starmed (CPAP) delivered by a helmet

Intervention Type PROCEDURE

Continuous Positive Airway Pressure delivered by a helmet with PEEP valve of 10 cmH2O and FiO2 0.5

2

O2 administration via a conventional Venturi mask

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Castar Starmed (CPAP) delivered by a helmet

Continuous Positive Airway Pressure delivered by a helmet with PEEP valve of 10 cmH2O and FiO2 0.5

Intervention Type PROCEDURE

Other Intervention Names

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Castar Starmed CP209/2

Eligibility Criteria

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Inclusion Criteria

* Community-acquired pneumonia (CAP) defined as: new chest x-ray pulmonary infiltrate, fever, and respiratory symptoms
* Acute Hypoxemic Respiratory failure
* Respiratory Rate \< 35 breaths/min
* PaO2/FiO2 \> 200 and \< 300 while breathing oxygen for at least 15 minutes via a Venturi mask with FiO2 0.5

Exclusion Criteria

* Immunosuppression
* acute cardiogenic pulmonary edema
* Patients belonging to Class II-III-IV of the NYHA
* Acute coronary syndrome
* Acute Respiratory Acidosis pH \< 7.35 and PaCO2 \> 45 mmHg
* More than 3 acute organ failures
* Systolic Pressure \< 90 mmHg under fluid resuscitation or vasopressor drug use
* Seizures
* Decreased level of consciousness (GCS \<12)
* Inability to clear secretions
* Pre-defined intubation criteria
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Milan

OTHER

Sponsor Role lead

Responsible Party

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Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena

Principal Investigators

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roberto cosentini, MD

Role: STUDY_CHAIR

Ospedale Maggiore Policlinico Mangiagalli e Regina Elena

Locations

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Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena

Milan, , Italy

Site Status

Countries

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Italy

References

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Gregg RW, Friedman BC, Williams JF, McGrath BJ, Zimmerman JE. Continuous positive airway pressure by face mask in Pneumocystis carinii pneumonia. Crit Care Med. 1990 Jan;18(1):21-4. doi: 10.1097/00003246-199001000-00006.

Reference Type BACKGROUND
PMID: 2403506 (View on PubMed)

Hilbert G, Gruson D, Vargas F, Valentino R, Chene G, Boiron JM, Pigneux A, Reiffers J, Gbikpi-Benissan G, Cardinaud JP. Noninvasive continuous positive airway pressure in neutropenic patients with acute respiratory failure requiring intensive care unit admission. Crit Care Med. 2000 Sep;28(9):3185-90. doi: 10.1097/00003246-200009000-00012.

Reference Type BACKGROUND
PMID: 11008980 (View on PubMed)

Cosentini R, Brambilla AM, Aliberti S, Bignamini A, Nava S, Maffei A, Martinotti R, Tarsia P, Monzani V, Pelosi P. Helmet continuous positive airway pressure vs oxygen therapy to improve oxygenation in community-acquired pneumonia: a randomized, controlled trial. Chest. 2010 Jul;138(1):114-20. doi: 10.1378/chest.09-2290. Epub 2010 Feb 12.

Reference Type DERIVED
PMID: 20154071 (View on PubMed)

Other Identifiers

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CAPOVeRSO 01

Identifier Type: -

Identifier Source: org_study_id