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Protective ventilation can be difficult to achieve during noninvasive ventilation for "de novo"acute hypoxemic respiratory failure (i.e., not due to exacerbation of chronic lung disease or cardiac failure).Recent data suggest patient self-inflicted lung injury (P-SILI) as a possible mechanism aggravating lung damage in these patients.
The aim of this study is evaluate the tidal volume, measured by respiratory inductance plethysmography, in patients receiving different non invasive respiratory support.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| spontaneous breathing trial | Placebo Comparator | the patients will be asked to breathe spontaneously using their actual low oxygen flow |
|
| High Flow Nasal cannula (HFNC) | Active Comparator | The patients will be asked to breathe with HFNC of 40 L/min |
|
| Helmet CPAP | Active Comparator | the patients will be asked to breathe with the Helmet CPAP |
|
| Non Invasive Ventilation (NIV) | Active Comparator | the patients will be asked to breathe with the support of a ventilator via a oro-nasal interface |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ventimask | Device | The patients will be asked to breathe spontaneously using their actual low oxygen flow |
|
| Measure | Description | Time Frame |
|---|---|---|
| respiratory pattern | the way the patient is breathing recorded by respiratory inductance plethysmography (RIP) | 30 minutes |
| respiratory mechanics | the inspiratory effort of the patient recorded by esophageal pressure | 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| changes in Arterial Blood Gases (ABGs) | Arterial Blood Gases, namely arterial oxygen (PaO2) and carbon dioxyde (PaCO2) tension will be analyzed from a sample taken from the arterial artery | immediately after intervention |
| Dyspnea score |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Stefano Nava, MD | Alma Mater Studiorum University of Bologna (IT)- Director of Respiratory and Critical Care Unit/ IRCSS S.Orsola-Malpighi University Hospital, Bologna (IT) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| IRCCS Policlinico di Sant'Orsola | Bologna | 40138 | Italy |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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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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| High Flow Nasal cannula (HFNC) | Device | The patients will be asked to breathe using high flow nasal cannula (HFNC). Air flow will set up to 60 l/m, temperature according to patient's comfort and FiO2 in order to obtain SpO2 values >/= 92% |
|
| Helmet CPAP | Device | The patients will be asked to breathe with Helmet. CPAP will set at 10 cmH2O and FiO2 in order to obtain SpO2 values >/= 92% |
|
| Non Invasive Ventilation (NIV) | Device | the patients will be asked to breathe with the support of a ventilator via a oro-nasal interface |
|
Dyspnea will be recorded using the Borg scale that is a numeric scale where 0 is no dyspnea and 10 the maximal dyspnea that a patient can imagine
| immediately after intervention |
| Comfort score | this will be assessed using a dedicated visual analog scale (VAS with a length of 20 cm) | immediately after intervention |
| Blood pressure (BP) and Heart rate (HR) measurements | blood pressure and heart rate will be assessed | 30 minutes |