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Sponsor: Rush University Medical Center
Conditions: Obesity, Morbid, Extubation Failure
Interventions: Noninvasive ventilation alternating with high flow nasal cannula, High flow nasal cannula
Countries: United States, Mexico
Around 20% of the obese patients with higher body mass index (BMI) who are taken off the breathing tube and breathing machine (ventilator) end up needing it back to support breathing. The re-application of breathing tube is associated with poor outcomes, including high risk of pneumonia, longer hospital stays, and death. The purpose of this study is to assess if prophylactic use of noninvasive breathing support after removing the breathing tube lowers the chance of needing the breathing tube again.
Sex: ALL
Age: 18 Years to —
Healthy volunteers: No
Study type: INTERVENTIONAL
Inclusion Criteria: 1. Adult, age ≥ 18 years old 2. Receiving invasive mechanical ventilation for ≥24 hours 3. BMI ≥40 kg/m2 4. Undergoing planned extubation per treating team 5. Arterial pH ≥7.35 or venous pH ≥ 7.31 within 30 mins of spontaneous breathing trial (SBT) Exclusion Criteria: 1. Pregnant 2. Use of extra-corporeal membrane oxygenation 3. Chronic tracheostomy in place 4. Unplanned or accidental extubation 5. Terminal/compassionate extubation 6. Contraindication to NIV use 7. Intubated because of an acute exacerbation of COPD 8. Underlying neuromuscular disease 9. No reintubation requested by patient/family 10. Documented/known history of chronic hypercapnic respiratory failure on home NIV (including bilevel PAP). 11. Enrolled in any other outcome study 12. Treating clinician feels that HFNC or NIV are either mandatory or contraindicated for a given patient
- Chicago, Illinois, United States
- Winfield, Illinois, United States
- Houston, Texas, United States
- Milwaukee, Wisconsin, United States
- Guadalajara, Jalisco, Mexico