Fibreoptic Bronchoscopy Assisted Intubation During Noninvasive Positive Pressure Ventilation

Study Overview
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Brief Summary
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This study is to investigate the efficiency and safety of fibreoptic bronchoscopy assisted intubation during noninvasive positive pressure ventilation in respiratory failure patients. Half of the participants will receive preoxygenation with noninvasive ventilator and fibreoptic bronchoscopy intubation during NIPPV. While the other half using usual preoxygenation(bag-mask ventilation ).

Detailed Description
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Respiratory failure is very common for critically ill patients, Main complication associated with intubation was desaturation. Usual preoxygenation( bag-mask ventilation) have been show that marginally effective in critically ill patients. As a result, there is a need to optimize the technique of preoxygenation to prolong the safe duration of apnea during the intubation procedure in critically ill patients. Noninvasive ventilation provides continuous positive airway pressure is effective in increasing the efficiency of gas exchange and in reducing the decrease in oxyhemoglobin saturation during fiberoptic bronchoscopy in hypoxemic patients. Therefore, our aim was to study whether NIPPV is more effective at reducing desaturation than usual preoxygenation in hypoxemic, critically ill patients requiring intubation in ICU.

Official Title
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The Efficiency and Safety of Fibreoptic Bronchoscopy Assisted Intubation During Noninvasive Positive Pressure Ventilation

Conditions
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Respiratory Failure

Intervention / Treatment
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* Procedure: Bag-mask ventilation
* Procedure: Noninvasive positive pressure ventilation(NIPPV)
* Procedure: fibreoptic bronchoscopy assisted intubation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute respiratory failure requiring intubation, Age greater than or equal to 18 years Exclusion Criteria: Nasal polyps，Nasopharyngeal cancer，Nasal bleeding，Rhinitis，Sinusitis and so on Nasal disease Basal skull fracture Severe coagulopathy, blood platelet counts <50×10*9/L Nose and facial deformities, trauma Cardiac arrest Pregnancy or puerpera

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Control<br>Preoxygenation with Bag-mask ventilation before fibreoptic bronchoscopy assisted intubation. Intervention: Bag-mask ventilation. | Procedure: Bag-mask ventilation<br>* The control group receives preoxygenation with bag-mask ventilation<br>Procedure: fibreoptic bronchoscopy assisted intubation<br>* All patients will receive fibreoptic bronchoscopy assisted intubation.<br>|
| Experimental: NIPPV<br>The NIPPV group preoxygenation with noninvasive positive pressure ventilation(NIPPV), And then receives fibreoptic bronchoscopy intubation through a face mask (there is a small hole allow to insert the tracheal tube through the mask into trachea) during NIPPV. Intervention: noninvasive positive pressure ventilation(NIPPV) | Procedure: Noninvasive positive pressure ventilation(NIPPV)<br>* The NIPPV group receives noninvasive positive pressure ventilation during fibreoptic bronchoscopy assisted intubation<br>Procedure: fibreoptic bronchoscopy assisted intubation<br>* All patients will receive fibreoptic bronchoscopy assisted intubation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in pulse oxymetry(SpO2) |  | From time of randomization until connect to ventilator 30min | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mechanical ventilation Time |  | 28 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bronchoscopy, Intubation, Noninvasive positive pressure ventilation