High-flow Air Via Nasal Cannula vs Non-invasive Continuous Positive Airway Pressure for Hypercapnic Respiratory Failure (HIGHforHyper)
Hypercapnic Respiratory Failure
About this trial
This is an interventional treatment trial for Hypercapnic Respiratory Failure
Eligibility Criteria
Inclusion Criteria:
- Adult patients (e.g. at least 18 years old) treated at the Emergency Department
- Acute hypercapnic respiratory failure defined as a pCO2 >50mmHg and a pH<7.30 on admission
Exclusion Criteria:
- Patients being comatose on admission, with no intact airway, lack of airway-protective reflexes, or those who are not alert enough to follow commands
- Patients intubated by Emergency Medical Service
- Patients requiring intubation on admission
- Pregnant women
Sites / Locations
- Medical University ViennaRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Intervention
Control
Intervention consists of HFA using standard equipment at the department. A gas flow of 60L/min and a FiO2 as clinically feasible will be used. Therapy will be continued until a pCO2-level of 50mmHg or less is reached, or therapy has to be aborted because of lack of tolerance by the pati ent or indication for intubation.
Control consists of non-invasive CPAP ventilation support using a tight mask and standard respirator equipment of the Department of Emergency Medicine. A positive airway pressure of 5cm H2O and a FiO2 as clinically feasible will be used. Therapy will be continued until a pCO2-level of 50mmHg or less is reached, or therapy has to be aborted because of lack of tolerance by the patient or indication for intubation.