RecruitingNCT05704881

Monitoring of the End-tidal Carbon Dioxide (EtCO2) as a Severity Criterion in COPD Exacerbations

Monitoring of the End-tidal Carbon Dioxide (EtCO2 ) as a Severity Criterion in COPD Exacerbations: a Prospective Observational Study

Sponsor

University Hospital, Grenoble

Enrollment

240 participants

Start Date

Mar 3, 2023

Study Type

OBSERVATIONAL

Conditions

Pulmonary Disease, Chronic Obstructive Exacerbation Copd

Summary

Although we know that these numbers are underestimated, Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease that affects between 8 and 12% of adults. According to a 2020 WHO report, it is the third most common cause of mortality in developed countries. This disease is punctuated by exacerbations associated with an 8% mortality of hospitalized patients, increased to 24% when the patient is admitted to intensive care unit. Early detection and treatment of these exacerbations appears to be essential to improve patient survival. End-tidal carbon dioxide (EtCO2) is used to assess a patient's respiratory and hemodynamic status. Indeed, EtCO2 is a non-invasive measure that could allow the estimation of arterial carbon dioxide (PaCO2) without performing blood gases, an arterial blood sampling, classically at the radial artery. This study aimed to find an EtCO2 value which at the time of the initial management, would be predictive of a severe COPD exacerbation, as well as PaCO2.

Eligibility

Min Age: 18 Years

Inclusion Criteria2

All patient presenting to the emergency department with acute dyspnea and with a history of COPD documented or reported by the patient and/or family
Male or female≥18 years old who did not oppose to participating in the study

Exclusion Criteria6

Hypotension (SBP \< 90 mmHg or MBP \< 65 mmHg)
Patient already included in the study during a previous visit to the emergency department
Patient already ventilated with invasive or NIV during admission to the emergency department
COPD exacerbation rejected after medical and additional examinations
Non-communicative or non-French speaking patients, or with impaired comprehension, or with impaired consciousness
Protected persons referred to in articles L1121-6 and L1121-8 of French public health code (deprived of liberty, tutorship or curatorship)

Interventions

DIAGNOSTIC_TESTEnd-Tidal CO2 measurement during COPD exacerbation

The EtCO2 will be measured at the emergency reception during assessment of vital signs by the nurse with the help of a mask or oxygen glasses measuring EtCO2. The patient will then be treated conventionally according to current international recommendations. The physician in charge of the patient will be blinded to this measurement. The outcome will be the initiation of invasive or non-invasive ventilation (NIV) within the first 24 hours of admission to the emergency department, as indicated by the physician in charge of the patient.