Predictors of HFNC Failure in Patients With AHRF Using Echocardiography Parameters

NCT ID: NCT06096363

Last Updated: 2024-10-16

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 28 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2023-04-28
• Study Completion Date: 2024-09-01

Brief Summary

Right ventricular dysfunction (RVD) and right ventricular-pulmonary arterial (RV-PA) uncoupling detected by transthoracic echocardiography (TTE) in acute respiratory distress syndrome (ARDS) are associated with poor survival. Early detection of RVD and RV-PA uncoupling in patients with acute hypoxemic respiratory failure (AHRF) may be indicative of worsening and decompensating pulmonary condition which may require escalation of respiratory support. The use of TTE parameters in predicting high-flow nasal cannula (HFNC) failure has not been previously studied. The objective of this study is to identify predictors of HFNC failure by TTE and to compare its performance with the well-established ROX index.

Conditions

Acute Hypoxemic Respiratory Failure

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Interventions

Transthoracic Echocardiography

Transthoracic Echocardiography to look for evidence of right ventricular (RV) dysfunction and right ventricular-pulmonary arterial (RV-PA) uncoupling.

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

Inclusion Criteria

• Age ≧ 18; AND
• Acute hypoxemic respiratory failure (AHRF), defined by respiratory rate of greater than 25 breaths per minute and a ratio of the PaO2 to the fraction of inspired oxygen (PaO2 / FiO2) of less than 300, and use of accessory muscles of respiration or paradoxical abdominal motion; AND
• Required ventilatory support with high-flow nasal cannula (HFNC)

Exclusion Criteria

• Patients suffering from hypercapnic respiratory failure; OR
• AHRF secondary to conditions that are indicated for non-invasive ventilation (NIV) (e.g. acute exacerbation of COPD, cardiogenic pulmonary edema); OR
• Use of NIV or invasive mechanical ventilation (IMV) prior to HFNC initiation; OR
• Patients with imminent need for endotracheal intubation and invasive mechanical ventilation (IMV); OR
• Patients with known or suspected diaphragm paralysis; OR
• Pregnancy; OR
• Patients with abdominal compartment syndrome; OR
• Use of HFNC for more than 12 hours prior to ICU admission; OR
• Patients with suboptimal echocardiographic image quality for data processing; OR

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 100 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Queen Mary Hospital, Hong Kong

OTHER

Sponsor Role: lead

Responsible Party

Wincy Wing-Sze Ng

Associate Consultant, Adult Intensive Care Unit

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Queen Mary Hospital

Hong Kong, , Hong Kong

Countries

Hong Kong

Other Identifiers

UW 23-086-01

Identifier Type: -

Identifier Source: org_study_id