RecruitingNot ApplicableNCT04471129

Non-invasive Ventilation and High-speed Oxygen Therapy Effects on Heart Function - HiFlow-Heart Study

Sponsor

University Hospital, Rouen

Enrollment

30 participants

Start Date

Sep 16, 2020

Study Type

INTERVENTIONAL

Conditions

Chronic Heart Failure

Summary

The investigators hypothesize that the airway pressures generated by High Flow Oxygen Therapy could have a beneficial impact in patients with heart failure, particularly by lowering capillary pulmonary arterial pressures. However, results compared to Non-Invasive Ventilation are difficult to predict due to the lack of data in the literature.

Eligibility

Min Age: 18 Years

Inclusion Criteria10

Major patient
Patient who has undergone cardiac surgery with extracorporeal circulation for more than 24 hours and has been extubated for at least 6 hours.
Pre-operative heart failure with left ventricular ejection fraction \< 40%.
Invasive monitoring by pulmonary arterial catheter (Swan-Ganz) with transpulmonary thermodilution and by radial arterial catheter intended for use in the intra- and post-operative monitoring of the patient.
Treatment with conventional oxygen therapy (O2C) without an increase in O2 flow for more than 30 minuts, without signs of hypoxemia (SpO292%)
Stable hemodynamic parameters: no changes in hemodynamic parameters (arterial pressures and pulmonary and cardiac index) by more than 10% over the 30 minutes prior to inclusion and no increase in cardiotropic medication for at least 30 minutes.
Patient with an oxygenation rate ≤ 6L
For women of child-bearing age: negative pregnancy test at inclusion
Person who has read and understood the information letter and signed the consent form
Affiliation to a social security scheme

Exclusion Criteria16

Contraindication to the use of NIV or HFO
Patient with orotracheal intubation or tracheotomy
Renal failure with hemodialysis or hemofiltration
Uncontrolled state of shock (PAS\<90 mmHg and/or cardiac index\<1.8 L/min/m² and/or norepinephrine\>0.2 μg/kg/min and/or dobutamine\>10 μg/kg/min)
Acute respiratory failure as defined by :
clinical signs: respiratory rate \>35/min, signs of struggle, SpO2\<92% on O2C
indication for treatment with NIV or HFO at the discretion of the clinician
oxygen dependency requiring O2C\>6L/min O2C flow at the oxygen mask
Chronic advanced respiratory disease
Chronic treatment with NIV or CPAP at home
Non-operated aortic or mitral insufficiency ≥ II/IV
Administration of loop diuretics within 3 hours prior to inclusion for intravenous forms and within 6 hours for oral forms.
Presence of altered consciousness defined by a Glasgow score \< 15/15 or cognitive dysfunction defined by a CAM-ICU score \> 0/4
Pregnant or parturient or nursing woman or proven lack of effective contraception
Person deprived of liberty by an administrative or judicial decision or person placed under judicial protection / subtutorship or guardianship
Person participating in another trial / having participated in another trial that may interfere with the procedures that are the subject of the research within a 4-week time frame