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High Flow Nasal Cannula in the Emergency Department (HFNC)

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ClinicalTrials.gov Identifier: NCT03460119
Recruitment Status : Completed
First Posted : March 9, 2018
Last Update Posted : March 9, 2018
Sponsor:
Information provided by (Responsible Party):
Hospital Italiano de Buenos Aires

Brief Summary:
The aim of this study was to describe the changes in respiratory rate, heart rate and dyspnea, before and after using HFNC in patients presenting to our emergency department with ARF.

Condition or disease Intervention/treatment
Acute Respiratory Failure Device: High Flow Nasal Cannula Oxygen

Detailed Description:
A retrospective cohort study was performed. To all adults presenting to the emergency department who used high flow nasal cannula to treat clinical signs of acute respiratory failure based on the presence of a breathing frequency ≥ 25 breath/min and increase work of breathing evidence by dyspnea, in-drawing, accessory-muscle use and/or diaphoresis despite conventional oxygen therapy ≥ 6 l/min. Demographic variables and clinical and gasometric parameters before and after two hours using HFNC were recorded.

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Study Type : Observational
Actual Enrollment : 43 participants
Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Use of High-Flow Nasal Cannula for Acute Respiratory Failure in the Emergency Department
Actual Study Start Date : July 1, 2015
Actual Primary Completion Date : January 31, 2017
Actual Study Completion Date : January 31, 2017



Intervention Details:
  • Device: High Flow Nasal Cannula Oxygen
    The high flow device that we used was an air oxygen blender (Whisper FlowⓇ), which allows FiO2 adjustment between 0.30 and 1.0 and can deliver a gas flow from 10 to 150 l/min. The gas mixture was routed from a heated humidifier (MR850 with MR 290 chamber) through a one line heated inspiratory circuit (RT241) to the subject at a temperature of 37°C via a nasal cannula (OptiflowⓇ).


Primary Outcome Measures :
  1. Heart Rate [ Time Frame: 2 hours ]
    The closest value of Heart Rate before starting HFNC, and two hours later was collected from the electronic clinical history.

  2. Respiratory Rate [ Time Frame: 2 hours ]
    The closest value of Respiratory Rate before starting HFNC, and two hours later was collected from the electronic clinical history.

  3. Dyspnea [ Time Frame: 2 hours ]
    The closest value of Dyspnea (Modified Borg Dyspnea scale) before starting HFNC, and two hours later was collected from the electronic clinical history. The Modified Borg Dyspnea Scale is a rated numerical score used to measure dyspnea. This scale has a minimum value of 0 ( represent no dyspnea) and a maximum value of 10 (worse dyspnea).


Secondary Outcome Measures :
  1. Initial HFNC setting [ Time Frame: 2 hours ]
    The gas flow rate and the fraction of inspired oxygen at the HFNC initiation of treatment were collected from the electronic clinical history.

  2. Acute respiratory failure etiology [ Time Frame: 3 minutes ]
    Presence of a breathing frequency ≥ 25 breath/min and increase work of breathing evidence by dyspnea, in-drawing, accessory-muscle use and/or diaphoresis despite conventional oxygen therapy ≥ 6 l/min.

  3. Average time of use the HFNC [ Time Frame: until 28 days ]
    The total hours of use of HFNC were collected from the electronic clinical history.

  4. Delay of HFNC treatment [ Time Frame: until 24hs ]
    The hours between the admission to HFNC initiation were collected from the electronic clinical history.

  5. Efficacy of HFNC treatment [ Time Frame: 28 days ]
    When the patient did not need for escalation to other non-invasive or invasive ventilatory support.

  6. Failure of HFNC treatment [ Time Frame: 28 days ]
    When the patient need non-invasive or invasive ventilatory support or died. The type of ventilatory support post-failure were collected from the electronic clinical history.

  7. Mortality rate at 28 day from ED admission [ Time Frame: 28 days ]
    The number of patients who died after requiring HFNCO were collected from the electronic clinical history

  8. Palliative Care [ Time Frame: 28 days ]
    Consensus between patient and/or patient´s family and the physician about the care for the terminally ill patient, provided by an organized health service



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients with and without a history of lung disease who used high flow nasal cannula. We defined clinical signs of acute respiratory failure based on the presence of a breathing frequency ≥ 25 breath/min and increase work of breathing evidence by dyspnea, in-drawing, accessory-muscle use and/or diaphoresis, despite conventional oxygen therapy ≥ 6 l/min.
Criteria

Inclusion Criteria:

  • patients aged ≥ 18 years
  • attended between July 1st, 2015 and January 31st , 2017 in the Emergency Department of the Hospital Italiano de Buenos Aires
  • with clinical signs of acute respiratory failure

Exclusion Criteria:

- Pulse oximetry > 90% breathing room air


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03460119


Sponsors and Collaborators
Hospital Italiano de Buenos Aires
Investigators
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Principal Investigator: Vanesa R Ruiz, RT Hospital Italiano de Buenos Aires
Publications:

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Responsible Party: Hospital Italiano de Buenos Aires
ClinicalTrials.gov Identifier: NCT03460119    
Other Study ID Numbers: 3106
First Posted: March 9, 2018    Key Record Dates
Last Update Posted: March 9, 2018
Last Verified: February 2018

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Hospital Italiano de Buenos Aires:
High Flow Nasal Cannula
Emergency department
Respiratory care
Additional relevant MeSH terms:
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Respiratory Insufficiency
Respiratory Distress Syndrome, Adult
Emergencies
Disease Attributes
Pathologic Processes
Respiration Disorders
Respiratory Tract Diseases
Lung Diseases