Name (Synonyms) | Correlation |
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Name (Synonyms) | Correlation |
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There are 2 clinical trials
We aim to investigate whether the use of Continuous Positive Airway Pressure using a Helmet device (Helmet CPAP) will increase the number of days alive and free of ventilator within 28 days compared to the use of a High Flow Nasal Cannula (HFNC) in patients admitted to Helsingborg Hospital, Sweden, suffering from COVID-19 and an acute hypoxic respiratory failure.
Description: Number of days alive and free of mechanical ventilation within 28 days. Patients who die within 28 days will be counted as 0 VFD. Time in ventilator will be counted in hours and rounded to whole days.
Measure: Ventilator-Free Days (VFD) Time: 28 daysDescription: Peripheral oxygen saturation divided by fraction of inspired oxygen
Measure: SpO2/FiO2-ratio Time: 1 hour after randomisationDescription: Visual scale (1-10)
Measure: Patient comfort Time: 24 hours after randomisationDescription: Min 0, Max 1
Measure: Frequency of endotracheal intubation Time: 28 daysDescription: Defined as pCO2 > 6 kPa in a venous blood gas. Min 0, Max ∞
Measure: Frequency of carbon dioxide rebreathing Time: 28 daysDescription: All-cause mortality. (180 days endpoint not in primary publication)
Measure: Days alive within Time: 28 days and 180 daysBackground: Patients with COVID-19 have a range of clinical spectrum from asymptomatic infection, mild illness, moderate infection requiring supplemental oxygen and severe infection requiring intensive care support. High flow nasal cannula (HFNC) oxygen therapy and noninvasive ventilation (NIV) may offer respiratory support to patients with COVID-19 complicated by acute hypoxemic respiratory failure if conventional oxygen therapy (COT) fails to maintain satisfactory oxygenation but whether these respiratory therapies would lead to airborne viral transmission is unknown. Aims: This study examines whether SARS-2 virus can be detected in small particles in the hospital isolation rooms in patients who receive a) HFNC, b) NIV via oronasal masks and c) conventional nasal cannula for respiratory failure. Method: A field test to be performed at the Prince of Wales hospital ward 12C single bed isolation room with 12 air changes/hr on patients (n=5 for each category of respiratory therapy) with confirmed COVID-19 who require treatment for respiratory failure with a) HFNC up to 60L/min, b) NIV via oronasal masks and c) conventional nasal cannula up to 5L/min of oxygen. While the patient is on respiratory support, we would position 3 stationary devices in the isolation room (one next to each side of the bed and another at the end of the bed) of the patient with confirmed COVID-19 infection, and sample the air for four hours continuously. Results & implications: If air sampling RTPCR and viral culture is positive, this would objectively confirm that HFNC and NIV require airborne precaution by healthcare workers during application.
Description: quantitative RTPCR from air samples
Measure: detection of viral RNA from one or more participants' air samples Time: within 4 hours after starting respiratory therapyDescription: quantitative RTPCR from upper airway swab
Measure: the nasopharyngeal flocked swab and throat swab viral load (log10 copies/mL) Time: up to 2 weeks