Closed-loop oxygen control improves oxygen therapy in acute hypoxemic respiratory failure patients under high flow nasal oxygen: a randomized cross-over study (the HILOOP study)

Autor: Roca, O, Caritg, O, Santafé, M, Ramos, FJ, Pacheco, A, García-de-Acilu, M, Ferrer, R, Schultz, MJ, Ricard, J-D
Přispěvatelé: Institut Català de la Salut, [Roca O, Ferrer R] Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca, Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CibeRes), Instituto de salud Carlos III, Madrid, Spain. [Caritg O, Santafé M, Ramos FJ, Pacheco A, García-de-Acilu M] Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca, Barcelona, Spain. [Schultz MJ] Department of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’, Amsterdam, The Netherlands. Nufeld Department of Medicine, University of Oxford, Oxford, UK. Mahidol University, Bangkok, Thailand. [Ricard JD] Service de Médecine Intensive Réanimation, DMU ESPRIT, Hôpital Louis Mourier, APHP, Université Paris Cité, Colombes, France. Inserm, Iame, Paris, France, Vall d'Hebron Barcelona Hospital Campus, Intensive Care Medicine, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, ACS - Diabetes & metabolism, ACS - Microcirculation
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Adult
enfermedades respiratorias::trastornos respiratorios::insuficiencia respiratoria [ENFERMEDADES]
Cross-Over Studies
Insuficiència respiratòria - Tractament
Closed-loop oxygen control
Oxygen Inhalation Therapy
COVID-19
Other subheadings::/therapy [Other subheadings]
Critical Care and Intensive Care Medicine
Acute respiratory failure
High-flow nasal oxygen
Nasal high-flow
Respiratory Tract Diseases::Respiration Disorders::Respiratory Insufficiency [DISEASES]
Oxygen
Therapeutics::Respiratory Therapy::Oxygen Inhalation Therapy [ANALYTICAL
DIAGNOSTIC AND THERAPEUTIC TECHNIQUES
AND EQUIPMENT]
High flow nasal cannula
Automatic oxygen titration
terapéutica::terapia respiratoria::tratamiento por inhalación de oxígeno [TÉCNICAS Y EQUIPOS ANALÍTICOS
DIAGNÓSTICOS Y TERAPÉUTICOS]
Cannula
Humans
Hypoxia
Respiratory Insufficiency
Pandemics
Oxigenoteràpia
Otros calificadores::/terapia [Otros calificadores]
Zdroj: Scientia
Critical Care, 26(1):108. Springer Science + Business Media
ISSN: 1364-8535
Popis: Background We aimed to assess the efficacy of a closed-loop oxygen control in critically ill patients with moderate to severe acute hypoxemic respiratory failure (AHRF) treated with high flow nasal oxygen (HFNO). Methods In this single-centre, single-blinded, randomized crossover study, adult patients with moderate to severe AHRF who were treated with HFNO (flow rate ≥ 40 L/min with FiO2 ≥ 0.30) were randomly assigned to start with a 4-h period of closed-loop oxygen control or 4-h period of manual oxygen titration, after which each patient was switched to the alternate therapy. The primary outcome was the percentage of time spent in the individualized optimal SpO2 range. Results Forty-five patients were included. Patients spent more time in the optimal SpO2 range with closed-loop oxygen control compared with manual titrations of oxygen (96.5 [93.5 to 98.9] % vs. 89 [77.4 to 95.9] %; p 2 range, and less time above the suboptimal range. Fewer number of manual adjustments per hour were needed with closed-loop oxygen control. The number of events of SpO2 Conclusions Closed-loop oxygen control improves oxygen administration in patients with moderate-to-severe AHRF treated with HFNO, increasing the percentage of time in the optimal oxygenation range and decreasing the workload of healthcare personnel. These results are especially relevant in a context of limited oxygen supply and high medical demand, such as the COVID-19 pandemic. Trial registration The HILOOP study was registered at www.clinicaltrials.gov under the identifier NCT04965844.
Databáze: OpenAIRE
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