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A retrospective cohort study of all patients treated for type II (hypercapnic) respiratory failure with either High-Flow Oxygen Therapy or Non-Invasive Ventilation in a general adult hospital.
We will compare various clinically relevant outcomes in patients treated for type II (hypercapnic) acute respiratory failure (ARF) with either High-Flow Nasal Cannula (HFNC) or Non-Invasive Ventilation (NIV) in a general adult hospital.
All patients treated with HFNC were treated with an Optiflow device (Fisher&Paykel). Various Bilevel positive airway pressure (BiPAP) devices were used during the study period.
All ventilatory parameters were set according to the treating physicians' preferences.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with type II ARF | All patients with type II respiratory failure that were deemed by the treating physician to require ventilatory support either with non-invasive ventilation (NIV) or High-Flow Nasal Cannula (HFNC). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Non-Invasive Ventilation | Device | Treatment with Non-Invasive Ventilation by BiPAP. Different BiPAP models are in use. Ventilation parameters set at the discretion of the treating physician. |
| Measure | Description | Time Frame |
|---|---|---|
| Failure of initial treatment (combined outcome) | Combined outcome of death or intubation or transition to another treatment modality or unplanned resumption of respiratory support | 48 hours post intervention |
| Death at 48h | Mortality in the 48h following the initial intervention | 48 hours post intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Mortality at 7d | Incidence of death in the 7 days after intervention | 7 days post intervention |
| Incidence of endotracheal intubation | The incidence of intubation |
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Inclusion Criteria:
Exclusion Criteria:
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All patients treated for respiratory II failure in the hospital, including patients treated on the general medical floors, in the emergency department, and in the intensive-care unit.
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| Name | Affiliation | Role |
|---|---|---|
| Ivan Pavlov, MD | Ivan Pavlov MD CP inc | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital de Verdun | Montreal | Quebec | H4G2A2 | Canada |
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|
| High-Flow Nasal Cannula | Device | Treatment with a High-Flow Nasal Cannula. The Optiflow device by Fisher&Paykel used in all cases. Flow and fraction of inspired oxygen (FiO2) parameters at the discretion of the treating physician. |
|
|
| For the whole length of hospital stay, up to a maximum of one year. |
| Length of stay | Duration of stay in the hospital, in days | For the whole length of hospital stay, up to a maximum of one year. |
| Duration of endotracheal intubation | Duration (in hours) of the first episode of endotracheal intubation, immediately following the failed intervention | For the whole length of hospital stay, up to a maximum of one year. |
| Incidence of intervention change | The incidence of patients who switch from Non-Invasive Ventilation to High-Flow Oxygen, and vice versa, due to treatment failure | For the whole length of hospital stay, up to a maximum of one year. |
| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| D012140 | Respiratory Tract Diseases |
| D029424 | Pulmonary Disease, Chronic Obstructive |
| D011014 | Pneumonia |
| D006935 | Hypercapnia |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D063087 | Noninvasive Ventilation |
| ID | Term |
|---|---|
| D012121 | Respiration, Artificial |
| D058109 | Airway Management |
| D013812 | Therapeutics |
| D012138 | Respiratory Therapy |
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