Comparison of high-flow nasal oxygen therapy and non-invasive ventilation in ICU patients with acute respiratory failure and a do-not-intubate orders: a multicentre prospective study OXYPAL
R. Robert
(1, 2)
,
D. Frasca
(2, 3, 4)
,
J. Badin
(5)
,
C. Girault
(6)
,
C. Guitton
(7)
,
M. Djibre
(8)
,
P. Beuret
(9)
,
J. Reignier
(10)
,
D. Benzekri-Llefevre
(11)
,
S. Demiri
(12, 13)
,
H. Rahmani
(14, 15)
,
L. A. Argaud
(16, 17)
,
E. I'Her
(18, 19)
,
S. Ehrmann
(20, 21, 22)
,
O. Lesieur
(23)
,
K. Kuteifan
(24)
,
F. Thouy
(25)
,
L. Federici
(26)
,
D. Thevenin
(27)
,
D. Contou
(28)
,
N. Terzi
(29)
,
S. Nseir
(30)
,
M. Thyrault
(31)
,
C. Vinsonneau
(32)
,
J. Audibert
(33)
,
J. Masse
(34)
,
A. Boyer
(35)
,
B. Guidet
(36)
,
R. Chelha
(37)
,
J. P. Quenot
(38)
,
G. Piton
(39, 40)
,
N. Aissaoui
(41)
,
A. W. Thille
(2, 1)
,
J. P. Frat
(1, 2)
1
CIC - Poitiers
2 CHU Poitiers - Centre hospitalier universitaire de Poitiers
3 Université de Poitiers - Faculté de Médecine et de Pharmacie
4 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch
5 CHB - Centre Hospitalier de Blois
6 CHU Rouen
7 Centre Hospitalier Le Mans (CH Le Mans)
8 CHU Tenon [AP-HP]
9 CH Roanne - Centre Hospitalier de Roanne
10 CHU Nantes - Centre hospitalier universitaire de Nantes
11 CHRO - Centre Hospitalier Régional d'Orléans
12 UMRS 1158 - Neurophysiologie Respiratoire Expérimentale et Clinique
13 CHU Pitié-Salpêtrière [AP-HP]
14 UNISTRA - Université de Strasbourg
15 CHU Strasbourg
16 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
17 Université de Lyon
18 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
19 LaTIM - Laboratoire de Traitement de l'Information Medicale
20 CIC - Centre d’Investigation Clinique [Tours] CIC 1415
21 Pathologies Respiratoires : Protéolyse et Aérosolthérapie
22 Réseau CRICS-TRIGGERSEP - Clinical Research in Intensive Care and Sepsis - TRIal Group for Global Evaluation and Research in SEPsis [CHU Limoges]
23 CH La Rochelle - Hôpital Saint-Louis de La Rochelle
24 CH E.Muller Mulhouse - Centre Hospitalier Emile Muller [Mulhouse]
25 CHU Gabriel Montpied [Clermont-Ferrand]
26 Hôpital Louis Mourier - AP-HP [Colombes]
27 Centre Hospitalier de Lens
28 Centre Hospitalier Victor Dupouy
29 CHU Grenoble
30 CIC Lille - Centre d'Investigation Clinique - Innovation Technologique de Lille - CIC 1403 - CIC 9301
31 Groupe Hospitalier Nord Essonne [Longjumeau]
32 CH Béthune Beuvry - Centre Hospitalier de Béthune Beuvry
33 Hôpital Louis Pasteur [Chartres]
34 UCL - Université catholique de Lille
35 Groupe hospitalier Pellegrin
36 CHU Saint-Antoine [AP-HP]
37 Centre Hospitalier Privé Claude Galien - Ramsay Santé
38 Service de Réanimation Médicale (CHU de Dijon)
39 UBFC - Université Bourgogne Franche-Comté [COMUE]
40 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
41 HEGP - Hôpital Européen Georges Pompidou [APHP]
2 CHU Poitiers - Centre hospitalier universitaire de Poitiers
3 Université de Poitiers - Faculté de Médecine et de Pharmacie
4 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch
5 CHB - Centre Hospitalier de Blois
6 CHU Rouen
7 Centre Hospitalier Le Mans (CH Le Mans)
8 CHU Tenon [AP-HP]
9 CH Roanne - Centre Hospitalier de Roanne
10 CHU Nantes - Centre hospitalier universitaire de Nantes
11 CHRO - Centre Hospitalier Régional d'Orléans
12 UMRS 1158 - Neurophysiologie Respiratoire Expérimentale et Clinique
13 CHU Pitié-Salpêtrière [AP-HP]
14 UNISTRA - Université de Strasbourg
15 CHU Strasbourg
16 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
17 Université de Lyon
18 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
19 LaTIM - Laboratoire de Traitement de l'Information Medicale
20 CIC - Centre d’Investigation Clinique [Tours] CIC 1415
21 Pathologies Respiratoires : Protéolyse et Aérosolthérapie
22 Réseau CRICS-TRIGGERSEP - Clinical Research in Intensive Care and Sepsis - TRIal Group for Global Evaluation and Research in SEPsis [CHU Limoges]
23 CH La Rochelle - Hôpital Saint-Louis de La Rochelle
24 CH E.Muller Mulhouse - Centre Hospitalier Emile Muller [Mulhouse]
25 CHU Gabriel Montpied [Clermont-Ferrand]
26 Hôpital Louis Mourier - AP-HP [Colombes]
27 Centre Hospitalier de Lens
28 Centre Hospitalier Victor Dupouy
29 CHU Grenoble
30 CIC Lille - Centre d'Investigation Clinique - Innovation Technologique de Lille - CIC 1403 - CIC 9301
31 Groupe Hospitalier Nord Essonne [Longjumeau]
32 CH Béthune Beuvry - Centre Hospitalier de Béthune Beuvry
33 Hôpital Louis Pasteur [Chartres]
34 UCL - Université catholique de Lille
35 Groupe hospitalier Pellegrin
36 CHU Saint-Antoine [AP-HP]
37 Centre Hospitalier Privé Claude Galien - Ramsay Santé
38 Service de Réanimation Médicale (CHU de Dijon)
39 UBFC - Université Bourgogne Franche-Comté [COMUE]
40 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
41 HEGP - Hôpital Européen Georges Pompidou [APHP]
N. Terzi
- Function : Author
- PersonId : 879054
- ORCID : 0000-0003-4036-6245
- IdRef : 120009579
S. Nseir
- Function : Author
- PersonId : 910837
- ORCID : 0000-0002-7618-0357
- IdRef : 103027351
A. Boyer
- Function : Author
- PersonId : 778324
- ORCID : 0000-0003-0838-0573
B. Guidet
- Function : Author
- PersonId : 988017
- IdHAL : bertrand-guidet
- ORCID : 0000-0002-7643-6770
- IdRef : 076134350
J. P. Quenot
- Function : Author
- PersonId : 998462
- ORCID : 0000-0003-2351-682X
- IdRef : 079287654
Abstract
INTRODUCTION: A palliative approach to intensive care unit (ICU) patients with acute respiratory failure and a do-not-intubate order corresponds to a poorly evaluated target for non-invasive oxygenation treatments. Survival alone should not be the only target; it also matters to avoid discomfort and to restore the patient's quality of life. We aim to conduct a prospective multicentre observational study to analyse clinical practices and their impact on outcomes of palliative high-flow nasal oxygen therapy (HFOT) and non-invasive ventilation (NIV) in ICU patients with do-not-intubate orders. METHODS AND ANALYSIS: This is an investigator-initiated, multicentre prospective observational cohort study comparing the three following strategies of oxygenation: HFOT alone, NIV alternating with HFOT and NIV alternating with standard oxygen in patients admitted in the ICU for acute respiratory failure with a do-not-intubate order. The primary outcome is the hospital survival within 14 days after ICU admission in patients weaned from NIV and HFOT. The sample size was estimated at a minimum of 330 patients divided into three groups according to the oxygenation strategy applied. The analysis takes into account confounding factors by modelling a propensity score. ETHICS AND DISSEMINATION: The study has been approved by the ethics committee and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03673631.
Origin : Publication funded by an institution