Tidal Volume in Patients With "de Novo" Acute Hypoxemic Respiratory Failure

NCT ID: NCT04741659

Last Updated: 2021-11-09

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

COMPLETED

Clinical Phase

NA

Total Enrollment

21 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-20

Study Completion Date

2021-07-30

Brief Summary

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Protective ventilation can be difficult to achieve during noninvasive ventilation for "de novo"acute hypoxemic respiratory failure (i.e., not due to exacerbation of chronic lung disease or cardiac failure).Recent data suggest patient self-inflicted lung injury (P-SILI) as a possible mechanism aggravating lung damage in these patients.

The aim of this study is evaluate the tidal volume, measured by respiratory inductance plethysmography, in patients receiving different non invasive respiratory support.

Detailed Description

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Conditions

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Acute Hypoxemic Respiratory Failure

Keywords

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De novo ARF

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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spontaneous breathing trial

the patients will be asked to breathe spontaneously using their actual low oxygen flow

Group Type PLACEBO_COMPARATOR

Ventimask

Intervention Type DEVICE

The patients will be asked to breathe spontaneously using their actual low oxygen flow

High Flow Nasal cannula (HFNC)

Intervention Type DEVICE

The patients will be asked to breathe using high flow nasal cannula (HFNC). Air flow will set up to 60 l/m, temperature according to patient's comfort and FiO2 in order to obtain SpO2 values \>/= 92%

Helmet CPAP

Intervention Type DEVICE

The patients will be asked to breathe with Helmet. CPAP will set at 10 cmH2O and FiO2 in order to obtain SpO2 values \>/= 92%

Non Invasive Ventilation (NIV)

Intervention Type DEVICE

the patients will be asked to breathe with the support of a ventilator via a oro-nasal interface

High Flow Nasal cannula (HFNC)

The patients will be asked to breathe with HFNC of 40 L/min

Group Type ACTIVE_COMPARATOR

Ventimask

Intervention Type DEVICE

The patients will be asked to breathe spontaneously using their actual low oxygen flow

High Flow Nasal cannula (HFNC)

Intervention Type DEVICE

The patients will be asked to breathe using high flow nasal cannula (HFNC). Air flow will set up to 60 l/m, temperature according to patient's comfort and FiO2 in order to obtain SpO2 values \>/= 92%

Helmet CPAP

Intervention Type DEVICE

The patients will be asked to breathe with Helmet. CPAP will set at 10 cmH2O and FiO2 in order to obtain SpO2 values \>/= 92%

Non Invasive Ventilation (NIV)

Intervention Type DEVICE

the patients will be asked to breathe with the support of a ventilator via a oro-nasal interface

Helmet CPAP

the patients will be asked to breathe with the Helmet CPAP

Group Type ACTIVE_COMPARATOR

Ventimask

Intervention Type DEVICE

The patients will be asked to breathe spontaneously using their actual low oxygen flow

High Flow Nasal cannula (HFNC)

Intervention Type DEVICE

The patients will be asked to breathe using high flow nasal cannula (HFNC). Air flow will set up to 60 l/m, temperature according to patient's comfort and FiO2 in order to obtain SpO2 values \>/= 92%

Helmet CPAP

Intervention Type DEVICE

The patients will be asked to breathe with Helmet. CPAP will set at 10 cmH2O and FiO2 in order to obtain SpO2 values \>/= 92%

Non Invasive Ventilation (NIV)

Intervention Type DEVICE

the patients will be asked to breathe with the support of a ventilator via a oro-nasal interface

Non Invasive Ventilation (NIV)

the patients will be asked to breathe with the support of a ventilator via a oro-nasal interface

Group Type ACTIVE_COMPARATOR

Ventimask

Intervention Type DEVICE

The patients will be asked to breathe spontaneously using their actual low oxygen flow

High Flow Nasal cannula (HFNC)

Intervention Type DEVICE

The patients will be asked to breathe using high flow nasal cannula (HFNC). Air flow will set up to 60 l/m, temperature according to patient's comfort and FiO2 in order to obtain SpO2 values \>/= 92%

Helmet CPAP

Intervention Type DEVICE

The patients will be asked to breathe with Helmet. CPAP will set at 10 cmH2O and FiO2 in order to obtain SpO2 values \>/= 92%

Non Invasive Ventilation (NIV)

Intervention Type DEVICE

the patients will be asked to breathe with the support of a ventilator via a oro-nasal interface

Interventions

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Ventimask

The patients will be asked to breathe spontaneously using their actual low oxygen flow

Intervention Type DEVICE

High Flow Nasal cannula (HFNC)

The patients will be asked to breathe using high flow nasal cannula (HFNC). Air flow will set up to 60 l/m, temperature according to patient's comfort and FiO2 in order to obtain SpO2 values \>/= 92%

Intervention Type DEVICE

Helmet CPAP

The patients will be asked to breathe with Helmet. CPAP will set at 10 cmH2O and FiO2 in order to obtain SpO2 values \>/= 92%

Intervention Type DEVICE

Non Invasive Ventilation (NIV)

the patients will be asked to breathe with the support of a ventilator via a oro-nasal interface

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Acute Respiratory Failure (ARF) ( 100 \<PaO2/FiO2 \<300) due to Covid-19 infection
* Informed consent
* Enrollment within the first 24 hours after ARF

Exclusion Criteria

* Clinical, radiological or istological evidence of chronic pulmonary disease.
* Body Mass Index (BMI) \> 30 kg/m2;
* Previous diagnosis of Obstructive sleep apnea syndrome (OSAS)
* Chest wall disease
* Heart failure
* Severe hemodynamic instability ( need for amine support)
* Acute coronary syndrome (ACS)
* Severe arrhythmia
* Patients unable to protect respiratory airways
* Respiratory arrest and need for endotracheal intubation
* Pregnancy
* Need for sedation
* Home long-term oxygen therapy
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS Azienda Ospedaliero-Universitaria di Bologna

OTHER

Sponsor Role lead

Responsible Party

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dr. Stefano Nava

Stefano Nava, Professor of Respiratory Medicine/ Alma Mater Studiorum University of Bologna (IT)- Director of Respiratory and Critical Care Unit/ S.Orsola-Malpighi University Hospital, Bologna (IT)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Stefano Nava, MD

Role: PRINCIPAL_INVESTIGATOR

Alma Mater Studiorum University of Bologna (IT)- Director of Respiratory and Critical Care Unit/ IRCSS S.Orsola-Malpighi University Hospital, Bologna (IT)

Locations

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IRCCS Policlinico di Sant'Orsola

Bologna, , Italy

Site Status

Countries

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Italy

Other Identifiers

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691/2020/Sper/AOUBo

Identifier Type: -

Identifier Source: org_study_id