Critically ill patients are predisposed to oxyhaemoglobin desaturation during intubation. For the intubation of hypoxemic patients, preoxygenation using non invasive ventilation (NIV) is more effective at reducing arterial oxyhaemoglobin desaturation than standard method.
Objectives: To find out whether NIV, as a preoxygenation method, is more effective at reducing the degree of organ dysfunction/failure than standard preoxygenation during the week following endotracheal intubation.
Primary Outcome Measures:
- The maximum Sequential organ failure assessment (SOFA) score observed during the first week following endotracheal intubation. [ Time Frame: the first week ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- The mean drop in SpO2 during endotracheal intubation. [ Time Frame: during the intubation ] [ Designated as safety issue: Yes ]
- Number of organ failures (SOFA score >2) [ Time Frame: during the 7 days after intubation ] [ Designated as safety issue: Yes ]
- ICU length of stay [ Time Frame: during the stay in reanimation ] [ Designated as safety issue: Yes ]
- Mortality [ Time Frame: in reanimation ] [ Designated as safety issue: No ]
| Estimated Enrollment: |
200 |
| Study Start Date: |
June 2007 |
| Estimated Study Completion Date: |
March 2009 |
| Estimated Primary Completion Date: |
March 2009 (Final data collection date for primary outcome measure) |
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1: Experimental
Non Invasive Ventilation
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Procedure: Non Invasive Ventilation
Non Invasive Ventilation
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During the inclusion period (at least 10 min and maximum 30 min), the patients ware a high FiO2 mask, driven by 10-15L/min oxygen and are randomly assigned to control or NIV group. Preoxygenation is then performed for a 3 minute period prior to a standardized rapid sequence intubation. For the control group, preoxygenation use a non-re-breather bag-valve mask driven by 15L/min oxygen. Patients allow to breath spontaneously with occasional assists (usual preoxygenation method). For the NIV group, pressure support mode is delivered by an ICU ventilator through a face mask adjusted to obtain an expired tidal volume of 7 to 10 mL/kg. The fraction of inspired oxygen (FiO2) was 100% and we used a PEEP level of 5 cmH2O.
Purpose
