RecruitingNot ApplicableNCT06084117

High Flow Nasal Oxygen for Exacerbation COPD

High Flow Nasal Oxygen For Hypercapnic, Acidotic Exacerbation Chronic Obstructive Pulmonary Disease


Sponsor

Franciscus Gasthuis

Enrollment

40 participants

Start Date

May 14, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

In this pilot study the feasibility of performing a larger trial to study the non-inferiority of High Flow Nasal Oxygen compared to non-invasive ventilation in patients with acute acidotic hypercapnic exacerbation of COPD wil be investigated


Eligibility

Min Age: 40 Years

Inclusion Criteria3

  • Known chronic obstructive pulmonary disease
  • Acute hypercapnic exacerbation of this condition, defined as: PaCO2\>45 mmHg or \>6.0 kPa and pH 7.20-7.35
  • Age \>40 years

Exclusion Criteria12

  • Asthma
  • Immediate need for intubation, based on clinical judgement of the attending physician.
  • Impossibility to apply either one of the two interventions
  • Patient not expected to give immediate or delayed informed consent (e.g. known cognitive impairment, dementia, active serious psychiatric disease, mental retardation).
  • Established home-NIV or home CPAP, known indication for home-NIV or CPAP (e.g. OSAS or obesitas hypoventilation syndrome).
  • Impeding death
  • Concurrent (respiratory) diseases that may influence treatment efficacy: acute heart infarction, cardiogenic lung edema, massive pulmonary embolism (intermediate-high risk or more). NB; pulmonary infections (viral and bacterial) are a common cause of exacerbation and are no reason for exclusion.
  • Other acute diseases that preclude participation in the trial such as hemodynamic instability (need for vasopressors), reduced consciousness with need for intubation, severe intoxication
  • Tracheostomized patients
  • Participation in other interventional trials
  • Impossibility to admit the patient to the participating ICU or monitored ward (e.g. medium care / high dependency unit, depending on local infrastructure).
  • Previous explicit (or written) objection to participation in research - bicarbonate \<20 mmol/L

Interventions

OTHERHFNO

Respiratory support with HFNO (as opposed to NIV, as per standard of care)

OTHERNIV

Respiratory support with Non-invasive ventilation, standard of care


Locations(4)

Reinier de Graaf

Delft, Netherlands

Franciscus Gasthuis & Vlietland

Rotterdam, Netherlands

Ikazia

Rotterdam, Netherlands

Haaglanden Medisch Centrum

The Hague, Netherlands

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NCT06084117


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