ReAcT CO2: A Study to Assess TcCO2 to Guide Acute NIV (ReAcTCO2)
Acute Hypercapnic Respiratory Failure
About this trial
This is an interventional health services research trial for Acute Hypercapnic Respiratory Failure
Eligibility Criteria
Inclusion Criteria: Patients aged18 years and over with hypercapnia, requiring acute NIV and who are admitted to the Emergency Department or Medical HDU and, who need arterial blood sampling for clinical reasons. Recruited ideally within 4 hours (but no later than 8 hours) of initiation of acute NIV in hospital. Exclusion Criteria: Reduced level of consciousness or agitation. Metabolic or mixed acidosis, serum bicarbonate < 24 mmol/L. Haemodynamic instability or reduced skin perfusion. Patients requiring more than 6litres/min (ormorethan60%) inspired oxygen through ventilator to maintain SpO2 of 88-92%. Need for multi-organ support e.g. inotropes or vasopressors or renal replacement therapy Arterial pH equal or less than 7.1 or carbon dioxide levels >15kPa as they are at risk of NIV failure and likely to require mechanical ventilation. Participating in any other interventional study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Arterial Blood Gas (ABG) arm - Control arm
transcutaneous CO2 arm
Patients in this arm will undergo arterial blood gas sampling to monitor CO2 as per the British Thoracic Society guidance which is standard practice.
Patients in this arm will undergo transcutaneous monitoring to monitor CO2. This will be the experimental arm.