NIV for Hypercapnic Respiratory Failure: AVAPS vs S/T BIPAP
Northwell Health
100 participants
Oct 7, 2023
INTERVENTIONAL
Conditions
Summary
The goal of this study is to compare two different modes of noninvasive ventilation in hypercapnic respiratory failure. The investigators will compare AVAPS and BIPAP S/T and hypothesize that AVAPS will result in a decreased length of stay in the ICU or on telemetry. Currently, noninvasive ventilation is the standard of care for hypercapnic respiratory failure. However, the most effective mode for patients with hypercapnic respiratory failure is unclear.
Eligibility
Inclusion Criteria6
- Provision of signed and dated informed consent form directly by the patient; consent can also be obtained via a legal patient representative/health care proxy/surrogate
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female, aged 18 or older
- Diagnosed with hypercapnic respiratory failure on admission (ABG)
- Admitted to Lenox Hill Hospital medical intensive care unit or telemetry unit
- Requiring noninvasive ventilation as determined by the treating physician for the treatment of hypercarbic respiratory failure
Exclusion Criteria14
- Patients who require ventilation at predetermined tidal volumes
- Patients who require rapid and frequent IPAP adjustments to maintain a consistent tidal volume
- Age less than 18 years of age
- Currently intubated
- Chronic tracheostomy
- Pregnancy
- Hypotension
- Epistaxis (nosebleed)
- Untreated pertussis
- Acute sinusitis or Otitis media
- Patients at risk of aspirating gastric contents
- Patients with lack of spontaneous respiratory drive
- Patients with the inability to maintain a patent airway or adequately clear secretions
- Prisoners or other institutionalized individuals
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Interventions
A setting on noninvasive ventilator that allows setting of maximum and minimum inspiratory pressure and sets a target tidal volume. The inspiratory pressure varies breath to breath to ensure pre-set tidal volume is delivered.
A setting on noninvasive ventilator that allows setting of inspiratory pressure, inspiratory time, expiratory pressure, and backup rate to deliver variable tidal volumes.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06047405