<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03787173</url>
  </required_header>
  <id_info>
    <org_study_id>2018-CHITS-01</org_study_id>
    <secondary_id>2018-A00658-47</secondary_id>
    <nct_id>NCT03787173</nct_id>
  </id_info>
  <brief_title>Patient-ventilator Synchronisation Study for Intensive Care Unit Patients</brief_title>
  <acronym>SyncAutoVNI</acronym>
  <official_title>Patient-ventilator Synchronisation Study in Non Invasive Ventilation for Intensive Care Unit Patients: Comparison Between Manual and Automated Ventilator Settings.</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Hamilton Medical AG</agency>
      <agency_class>Industry</agency_class>
    </collaborator>
  </sponsors>
  <source>Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      This cross-over study will compare the asynchrony index between standard manual ventilator&#xD;
      settings, optimized manual ventilator settings, and automated ventilator setting in intensive&#xD;
      care patients ventilated in non-invasive ventilation with a high asynchrony index. The&#xD;
      hypothesis is that both manual optimized ventilator settings and automated ventilator&#xD;
      settings are associated with a lower patient-ventilator asynchrony index as compared to&#xD;
      manual standard ventilator settings.&#xD;
&#xD;
      A randomized cross-over design method will be used. Patient requiring NIV with an asynchrony&#xD;
      index over 35% will be included. An esophageal catheter with a balloon will be inserted to&#xD;
      monitor esophageal pressure. Patients will be ventilated during 3 periods of 30 min, with 10&#xD;
      minutes of washout in between. Recordings of airway pressure, airway flow, and esophageal&#xD;
      pressure will be analyzed by two investigators blinded of the trigger settings.&#xD;
&#xD;
      The primary outcome will be the asynchrony index. The secondary outcome will be the&#xD;
      ineffective inspiratory effort index, autotrigering index, double triggering index,&#xD;
      inspiratory trigger delay, cycling delay, total time spent in asynchrony, patient comfort,&#xD;
      and blood gas results.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Non-invasive ventilation (NIV) is used in 35% of patient admitted in intensive care unit&#xD;
      (ICU) with a failure rate of 10 to 70% depending on the indication and clinician experience.&#xD;
      Patient-ventilator asynchrony is a frequent cause of NIV failure. Therefore, optimizing&#xD;
      patient-ventilator synchronization is important for its comfort, tolerance, and efficacy. An&#xD;
      optimal patient-ventilation is achieved when the mechanical breath provided by the ventilator&#xD;
      match the patient inspiratory effort. The ratio between the number of asynchronies divided by&#xD;
      the number of patient inspiratory effort define the asynchrony index (AI). AI over 10% is&#xD;
      considered as severe and occurs in 30 to 43% of patients ventilated in NIV. Patient&#xD;
      ventilator asynchronies occurs because ventilator settings of inspiratory and expiratory&#xD;
      triggers remain constant in patient with variable respiratory drive, and unintentionnals&#xD;
      leaks that are difficult to control in NIV. Thus using an automatic adjustment of inspiratory&#xD;
      and expiratory triggers setting according to patient effort and unintentional leaks may&#xD;
      decrease the number of patient-ventilator asynchronies. This cross-over study will compare&#xD;
      the asynchrony index between standard manual ventilator settings, optimized manual ventilator&#xD;
      settings, and automated ventilator setting in intensive care patients ventilated in&#xD;
      non-invasive ventilation with a high asynchrony index. The hypothesis is that both manual&#xD;
      optimized ventilator settings and automated ventilator settings are associated with a lower&#xD;
      patient-ventilator asynchrony index as compared to manual standard ventilator settings.&#xD;
&#xD;
      A randomized cross-over design method will be used. Patient requiring NIV with an asynchrony&#xD;
      index over 30% will be included. An esophageal catheter with a balloon will be inserted to&#xD;
      monitor esophageal pressure. Patients will be ventilated during 3 periods of 30 min, with 10&#xD;
      minutes of washout in between. Recordings of airway pressure, airway flow, and esophageal&#xD;
      pressure will be analyzed by two investigators blinded of the trigger settings.&#xD;
&#xD;
      The primary outcome will be the asynchrony index. The secondary outcome will be the&#xD;
      ineffective inspiratory effort index, autotrigering index, double triggering index,&#xD;
      inspiratory trigger delay, cycling delay, total time spent in asynchrony, patient comfort,&#xD;
      and blood gas results.&#xD;
&#xD;
      The sample size was calculated from the total asynchrony index (primary outcome). Patients&#xD;
      with an asynchrony index over 30% in using manual standard ventilator settings will be&#xD;
      included. Considering an asynchrony index of 30 ± 15 % in manual standard ventilator settings&#xD;
      with a clinically significant objective to reduce the asynchrony index to 15% in manual&#xD;
      optimized ventilator settings and automated ventilator settings, a sample size of 30 patients&#xD;
      is required with a risk at 0.05 and a power at 80%. Therefore, 35 patients are planned.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date type="Actual">April 17, 2019</start_date>
  <completion_date type="Anticipated">April 16, 2024</completion_date>
  <primary_completion_date type="Anticipated">April 16, 2024</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Crossover Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Participant)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Asynchrony index</measure>
    <time_frame>Continuous measurement over 30min</time_frame>
    <description>Ratio between the total number of asynchronies divided by the number of patient inspiratory effort</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Lineffective inspiratory effort index</measure>
    <time_frame>Continuous measurement over 30min</time_frame>
    <description>Ratio between the total number of ineffective inspiratory effort divided by the number of patient inspiratory effort</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Autotrigering index</measure>
    <time_frame>Continuous measurement over 30min</time_frame>
    <description>Ratio between the total number of autotriggered breath divided by the number of patient inspiratory effort</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Double triggering index</measure>
    <time_frame>Continuous measurement over 30min</time_frame>
    <description>Ratio between the total number of double triggered breath divided by the number of patient inspiratory effort</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Inspiratory trigger delay</measure>
    <time_frame>Continuous measurement over 30min</time_frame>
    <description>Time between the beginning of patient effort assessed on oesophageal pressure and beginning of mechanical breath.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Cycling delay</measure>
    <time_frame>Continuous measurement over 30min</time_frame>
    <description>Time between the end of patient effort assessed on oesophageal pressure and the end of mechanical breath.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Total time spent in asynchrony</measure>
    <time_frame>Continuous measurement over 30min</time_frame>
    <description>Ratio of total time of ineffective inspiratory effort, inspiratory trigger delay, and cycling delay on total time of recording.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Patient comfort</measure>
    <time_frame>1 day (Single measurement)</time_frame>
    <description>Visual analog scale of Likert type measuring patient comfort going from 0 (very uncomfortable) to 10 (very comfortable)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Blood PaO2 results</measure>
    <time_frame>After each period at 30 min, 1 h and 1 h 30 min</time_frame>
    <description>PaO2</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Blood PaCO2 results</measure>
    <time_frame>After each period at 30 min, 1 h and 1 h 30 min</time_frame>
    <description>PaCO2</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Blood pH results</measure>
    <time_frame>After each period at 30 min, 1 h and 1 h 30 min</time_frame>
    <description>pH</description>
  </secondary_outcome>
  <number_of_arms>3</number_of_arms>
  <enrollment type="Anticipated">35</enrollment>
  <condition>Acute Respiratory Failure</condition>
  <arm_group>
    <arm_group_label>Manual standard ventilator settings</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>Inspiratory trigger set at 2 l/min, Expiratory trigger set at 25% of peak inspiratory flow</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Manual optimized ventilator settings</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Inspiratory trigger and Expiratory trigger settings optimized by investigator</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Automated ventilator settings</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Inspiratory trigger and Expiratory trigger settings automatized</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Optimized</intervention_name>
    <description>Inspiratory trigger and Expiratory trigger settings optimized by investigator</description>
    <arm_group_label>Manual optimized ventilator settings</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Automated</intervention_name>
    <description>Inspiratory trigger and Expiratory trigger settings automatized</description>
    <arm_group_label>Automated ventilator settings</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Patient aged over 18 years old&#xD;
&#xD;
          -  Covered by social insurance&#xD;
&#xD;
          -  Consent for study signed by patient or next-of-kin&#xD;
&#xD;
          -  NIV session indicated for at least 2 hours&#xD;
&#xD;
          -  Asynchrony index ≥ 30% with standard manual settings&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Patient requiring continuous NIV&#xD;
&#xD;
          -  Contra-indication to esophageal catheter insertion: gastric ulcer, esophageal varices,&#xD;
             pharyngeal or laryngeal tumor.&#xD;
&#xD;
          -  Patient with withholding decision about intubation&#xD;
&#xD;
          -  Moribund patient&#xD;
&#xD;
          -  Patient included in another interventional study in the last 30 days&#xD;
&#xD;
          -  Patient that does not speak French&#xD;
&#xD;
          -  Pregnant women&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Aude Garnero, MD</last_name>
    <role>Study Director</role>
    <affiliation>Centre Hospitalier Intercommunal Toulon La Seyne sur Mer</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Asmaa Jobic</last_name>
    <phone>04.83.77.20.61</phone>
    <phone_ext>+33</phone_ext>
    <email>asmaa.jobic@ch-toulon.fr</email>
  </overall_contact>
  <location>
    <facility>
      <name>Centre Hospitalier Intercommunal Toulon La Seyne sur Mer</name>
      <address>
        <city>Toulon</city>
        <state>Var</state>
        <zip>83056</zip>
        <country>France</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Aude Garnero, MD</last_name>
      <phone>04 94 14 58 62</phone>
      <phone_ext>+33</phone_ext>
      <email>aude.garnero@gmail.com</email>
    </contact>
    <investigator>
      <last_name>Jean-Michel Arnal, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>France</country>
  </location_countries>
  <reference>
    <citation>Demoule A, Chevret S, Carlucci A, Kouatchet A, Jaber S, Meziani F, Schmidt M, Schnell D, Clergue C, Aboab J, Rabbat A, Eon B, Guerin C, Georges H, Zuber B, Dellamonica J, Das V, Cousson J, Perez D, Brochard L, Azoulay E; oVNI Study Group; REVA Network (Research Network in Mechanical Ventilation). Changing use of noninvasive ventilation in critically ill patients: trends over 15 years in francophone countries. Intensive Care Med. 2016 Jan;42(1):82-92. doi: 10.1007/s00134-015-4087-4. Epub 2015 Oct 13.</citation>
    <PMID>26464393</PMID>
  </reference>
  <reference>
    <citation>Demoule A, Girou E, Richard JC, Taille S, Brochard L. Increased use of noninvasive ventilation in French intensive care units. Intensive Care Med. 2006 Nov;32(11):1747-55. doi: 10.1007/s00134-006-0229-z. Epub 2006 Jun 24.</citation>
    <PMID>16799775</PMID>
  </reference>
  <reference>
    <citation>Keenan SP, Sinuff T, Burns KE, Muscedere J, Kutsogiannis J, Mehta S, Cook DJ, Ayas N, Adhikari NK, Hand L, Scales DC, Pagnotta R, Lazosky L, Rocker G, Dial S, Laupland K, Sanders K, Dodek P; Canadian Critical Care Trials Group/Canadian Critical Care Society Noninvasive Ventilation Guidelines Group. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ. 2011 Feb 22;183(3):E195-214. doi: 10.1503/cmaj.100071. Epub 2011 Feb 14. No abstract available.</citation>
    <PMID>21324867</PMID>
  </reference>
  <reference>
    <citation>Ferrer M, Valencia M, Nicolas JM, Bernadich O, Badia JR, Torres A. Early noninvasive ventilation averts extubation failure in patients at risk: a randomized trial. Am J Respir Crit Care Med. 2006 Jan 15;173(2):164-70. doi: 10.1164/rccm.200505-718OC. Epub 2005 Oct 13.</citation>
    <PMID>16224108</PMID>
  </reference>
  <reference>
    <citation>El-Solh AA, Aquilina A, Pineda L, Dhanvantri V, Grant B, Bouquin P. Noninvasive ventilation for prevention of post-extubation respiratory failure in obese patients. Eur Respir J. 2006 Sep;28(3):588-95. doi: 10.1183/09031936.06.00150705. Epub 2006 May 31.</citation>
    <PMID>16737982</PMID>
  </reference>
  <verification_date>March 2023</verification_date>
  <study_first_submitted>December 20, 2018</study_first_submitted>
  <study_first_submitted_qc>December 24, 2018</study_first_submitted_qc>
  <study_first_posted type="Actual">December 26, 2018</study_first_posted>
  <last_update_submitted>March 20, 2023</last_update_submitted>
  <last_update_submitted_qc>March 20, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">March 21, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>non invasive ventilation</keyword>
  <keyword>patient ventilator synchrony</keyword>
  <keyword>acute respiratory failure</keyword>
  <keyword>closed loop ventilation</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Respiratory Insufficiency</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03787173
org study id: 2018-CHITS-01
secondary id: 2018-A00658-47
nct id: NCT03787173
lead sponsor: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
This cross-over study will compare the asynchrony index between standard manual ventilator
      settings, optimized manual ventilator settings, and automated ventilator setting in intensive
      care patients ventilated in non-invasive ventilation with a high asynchrony index. The
      hypothesis is that both manual optimized ventilator settings and automated ventilator
      settings are associated with a lower patient-ventilator asynchrony index as compared to
      manual standard ventilator settings.

      A randomized cross-over design method will be used. Patient requiring NIV with an asynchrony
      index over 35% will be included. An esophageal catheter with a balloon will be inserted to
      monitor esophageal pressure. Patients will be ventilated during 3 periods of 30 min, with 10
      minutes of washout in between. Recordings of airway pressure, airway flow, and esophageal
      pressure will be analyzed by two investigators blinded of the trigger settings.

      The primary outcome will be the asynchrony index. The secondary outcome will be the
      ineffective inspiratory effort index, autotrigering index, double triggering index,
      inspiratory trigger delay, cycling delay, total time spent in asynchrony, patient comfort,
      and blood gas results.
Non-invasive ventilation (NIV) is used in 35% of patient admitted in intensive care unit
      (ICU) with a failure rate of 10 to 70% depending on the indication and clinician experience.
      Patient-ventilator asynchrony is a frequent cause of NIV failure. Therefore, optimizing
      patient-ventilator synchronization is important for its comfort, tolerance, and efficacy. An
      optimal patient-ventilation is achieved when the mechanical breath provided by the ventilator
      match the patient inspiratory effort. The ratio between the number of asynchronies divided by
      the number of patient inspiratory effort define the asynchrony index (AI). AI over 10% is
      considered as severe and occurs in 30 to 43% of patients ventilated in NIV. Patient
      ventilator asynchronies occurs because ventilator settings of inspiratory and expiratory
      triggers remain constant in patient with variable respiratory drive, and unintentionnals
      leaks that are difficult to control in NIV. Thus using an automatic adjustment of inspiratory
      and expiratory triggers setting according to patient effort and unintentional leaks may
      decrease the number of patient-ventilator asynchronies. This cross-over study will compare
      the asynchrony index between standard manual ventilator settings, optimized manual ventilator
      settings, and automated ventilator setting in intensive care patients ventilated in
      non-invasive ventilation with a high asynchrony index. The hypothesis is that both manual
      optimized ventilator settings and automated ventilator settings are associated with a lower
      patient-ventilator asynchrony index as compared to manual standard ventilator settings.

      A randomized cross-over design method will be used. Patient requiring NIV with an asynchrony
      index over 30% will be included. An esophageal catheter with a balloon will be inserted to
      monitor esophageal pressure. Patients will be ventilated during 3 periods of 30 min, with 10
      minutes of washout in between. Recordings of airway pressure, airway flow, and esophageal
      pressure will be analyzed by two investigators blinded of the trigger settings.

      The primary outcome will be the asynchrony index. The secondary outcome will be the
      ineffective inspiratory effort index, autotrigering index, double triggering index,
      inspiratory trigger delay, cycling delay, total time spent in asynchrony, patient comfort,
      and blood gas results.

      The sample size was calculated from the total asynchrony index (primary outcome). Patients
      with an asynchrony index over 30% in using manual standard ventilator settings will be
      included. Considering an asynchrony index of 30 ± 15 % in manual standard ventilator settings
      with a clinically significant objective to reduce the asynchrony index to 15% in manual
      optimized ventilator settings and automated ventilator settings, a sample size of 30 patients
      is required with a risk at 0.05 and a power at 80%. Therefore, 35 patients are planned.
allocation: Randomized
intervention model: Crossover Assignment
primary purpose: Treatment
masking: Single (Participant)
measure: Asynchrony index
time frame: Continuous measurement over 30min
description: Ratio between the total number of asynchronies divided by the number of patient inspiratory effort
measure: Lineffective inspiratory effort index
time frame: Continuous measurement over 30min
description: Ratio between the total number of ineffective inspiratory effort divided by the number of patient inspiratory effort
measure: Autotrigering index
time frame: Continuous measurement over 30min
description: Ratio between the total number of autotriggered breath divided by the number of patient inspiratory effort
measure: Double triggering index
time frame: Continuous measurement over 30min
description: Ratio between the total number of double triggered breath divided by the number of patient inspiratory effort
measure: Inspiratory trigger delay
time frame: Continuous measurement over 30min
description: Time between the beginning of patient effort assessed on oesophageal pressure and beginning of mechanical breath.
measure: Cycling delay
time frame: Continuous measurement over 30min
description: Time between the end of patient effort assessed on oesophageal pressure and the end of mechanical breath.
measure: Total time spent in asynchrony
time frame: Continuous measurement over 30min
description: Ratio of total time of ineffective inspiratory effort, inspiratory trigger delay, and cycling delay on total time of recording.
measure: Patient comfort
time frame: 1 day (Single measurement)
description: Visual analog scale of Likert type measuring patient comfort going from 0 (very uncomfortable) to 10 (very comfortable)
measure: Blood PaO2 results
time frame: After each period at 30 min, 1 h and 1 h 30 min
description: PaO2
measure: Blood PaCO2 results
time frame: After each period at 30 min, 1 h and 1 h 30 min
description: PaCO2
measure: Blood pH results
time frame: After each period at 30 min, 1 h and 1 h 30 min
description: pH
arm group label: Manual standard ventilator settings
arm group type: No Intervention
description: Inspiratory trigger set at 2 l/min, Expiratory trigger set at 25% of peak inspiratory flow
arm group label: Manual optimized ventilator settings
arm group type: Active Comparator
description: Inspiratory trigger and Expiratory trigger settings optimized by investigator
arm group label: Automated ventilator settings
arm group type: Experimental
description: Inspiratory trigger and Expiratory trigger settings automatized
intervention type: Device
intervention name: Optimized
description: Inspiratory trigger and Expiratory trigger settings optimized by investigator
arm group label: Manual optimized ventilator settings
intervention type: Device
intervention name: Automated
description: Inspiratory trigger and Expiratory trigger settings automatized
arm group label: Automated ventilator settings
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Aude Garnero, MD
role: Study Director
affiliation: Centre Hospitalier Intercommunal Toulon La Seyne sur Mer
last name: Asmaa Jobic
phone: 04.83.77.20.61
phone ext: +33
email: asmaa.jobic@ch-toulon.fr
facility: 
status: Recruiting
contact: 
investigator: 
country: France
citation: Demoule A, Chevret S, Carlucci A, Kouatchet A, Jaber S, Meziani F, Schmidt M, Schnell D, Clergue C, Aboab J, Rabbat A, Eon B, Guerin C, Georges H, Zuber B, Dellamonica J, Das V, Cousson J, Perez D, Brochard L, Azoulay E; oVNI Study Group; REVA Network (Research Network in Mechanical Ventilation). Changing use of noninvasive ventilation in critically ill patients: trends over 15 years in francophone countries. Intensive Care Med. 2016 Jan;42(1):82-92. doi: 10.1007/s00134-015-4087-4. Epub 2015 Oct 13.
PMID: 26464393
citation: Demoule A, Girou E, Richard JC, Taille S, Brochard L. Increased use of noninvasive ventilation in French intensive care units. Intensive Care Med. 2006 Nov;32(11):1747-55. doi: 10.1007/s00134-006-0229-z. Epub 2006 Jun 24.
PMID: 16799775
citation: Keenan SP, Sinuff T, Burns KE, Muscedere J, Kutsogiannis J, Mehta S, Cook DJ, Ayas N, Adhikari NK, Hand L, Scales DC, Pagnotta R, Lazosky L, Rocker G, Dial S, Laupland K, Sanders K, Dodek P; Canadian Critical Care Trials Group/Canadian Critical Care Society Noninvasive Ventilation Guidelines Group. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ. 2011 Feb 22;183(3):E195-214. doi: 10.1503/cmaj.100071. Epub 2011 Feb 14. No abstract available.
PMID: 21324867
citation: Ferrer M, Valencia M, Nicolas JM, Bernadich O, Badia JR, Torres A. Early noninvasive ventilation averts extubation failure in patients at risk: a randomized trial. Am J Respir Crit Care Med. 2006 Jan 15;173(2):164-70. doi: 10.1164/rccm.200505-718OC. Epub 2005 Oct 13.
PMID: 16224108
citation: El-Solh AA, Aquilina A, Pineda L, Dhanvantri V, Grant B, Bouquin P. Noninvasive ventilation for prevention of post-extubation respiratory failure in obese patients. Eur Respir J. 2006 Sep;28(3):588-95. doi: 10.1183/09031936.06.00150705. Epub 2006 May 31.
PMID: 16737982
responsible party type: Sponsor
mesh term: Respiratory Insufficiency
sharing ipd: No