Clinical trial NCT05741697: HFNC in Management of Bronchiectasis Exacerbation
Official title: High Flow Nasal Cannula Versus Non-invasive Ventilation in Managing Acute Exacerbation of Bronchiectasis Patients
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Bronchiectasis
Lead sponsor: Assiut University
Sponsor class: OTHER
Collaborators: name: WGEKHALEEL
name: AARMHUSSIEN
First posted: 2023-02-23
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients will be eligible for enrolment if diagnosed with bronchiectasis and admitted to the respiratory intensive care unit (RICU), requiring ventilator support without invasive mechanical ventilation.

Brief summary: Patients with Bronchiectasis experience exacerbations with hypercapnic respiratory failure associated with an increased respiratory workload that may require intensive care unit (ICU) admission due to the inability of the respiratory muscles to compensate for increased demand. These exacerbations are frequently treated with noninvasive ventilation (NIV).

Detailed description: NIV has been shown to unload the respiratory muscles, increase alveolar ventilation and gas exchange and reverse the rapid and shallow breathing pattern commonly adopted by bronchiectasis patients with advanced lung disease.

NIV is a cornerstone therapy for hypercapnic acute respiratory failure. Still, there is also an increasing interest in high-flow nasal cannula (HFNC) as a potential alternative treatment in this indication. HFNC delivers an actively heated and fully humidified gas mixture with flow rates up to 60 L/min and adjustable FiO2 from 21 to 100%. The high flow rates generate small amounts of positive end-expiratory pressure (PEEP) that may help counterbalance the effects of intrinsic PEEP (PEEPi) on the work of breathing and might act by washing out of the physiological dead space. Furthermore, it could help to facilitate secretion clearance from the humidified gas.

Studies have demonstrated the benefits of HFNC in acute hypoxemic respiratory failure, after cardiothoracic surgery, and in preventing post-extubation failure among unselected cohorts of critically ill patients during weaning from invasive mechanical ventilation.

However, the current evidence of using HFNC in patients with hypercapnic acute respiratory failure is limited. We aime to spotlight this research area.

Eligibility criteria: Inclusion Criteria:

* Patients will be eligible for enrolment if diagnosed with bronchiectasis and admitted to the respiratory intensive care unit (RICU), requiring ventilator support without invasive mechanical ventilation.

Exclusion Criteria:

* Age: less than 18 years. Patients with post-arrest encephalopathy. Patient with the previous tracheotomy. Patients who received invasive ventilatory support. Patients with end-organ failure.

Primary outcomes:
measure: Assessment of efficacy and patient compliance of high flow nasal canula system in comparison to Noninvasive mechanical ventilation in management of acute exacerbation of Bronchiectasis
timeFrame: March 2023 to December 2023
Secondary outcomes:
Other outcomes:
Locations:
city: Assiut
country: Egypt
facility: Assiut University-Faculty of medicine
Study officials:
affiliation: Assiut University
name: Ahmad M. Shaddad
role: PRINCIPAL_INVESTIGATOR
References: