A multicenter randomized controlled trial of a 3-L/kg/min versus 2-L/kg/min high-flow nasal cannula flow rate in young infants with severe viral bronchiolitis (TRAMONTANE 2)
| العنوان: | A multicenter randomized controlled trial of a 3-L/kg/min versus 2-L/kg/min high-flow nasal cannula flow rate in young infants with severe viral bronchiolitis (TRAMONTANE 2) |
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| المؤلفون: | Milesi, Christophe, PIERRE, Anne-Florence, DEHO, Anna, POUYAU, Robin, Liet, Jean-Michel, Guillot, Camille, GUILBERT, Anne-Sophie, Rambaud, Jérôme, MILLET, Astrid, Afanetti, Mickael, GUICHOUX, Julie, GENUINI, Mathieu, MANSIR, Thierry, Bergounioux, Jean, Michel, Fabrice, Marcoux, Marie-Odile, Baleine, Julien, Durand, Sabine, Durand, Philippe, Dauger, Stéphane, Javouhey, Etienne, Leteurtre, Stéphane, Brissaud, Olivier, Renolleau, Sylvain, PORTEFAIX, Aurélie, Douillard, Aymeric, Cambonie, Gilles, FOR THE GFRUP RESPIRATORY STUDY GROUP, for the GFRUP Respiratory Study Group |
| المساهمون: | Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR T9405), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Université de Montpellier (UM) |
| المصدر: | Intensive Care Medicine Intensive Care Medicine, Springer Verlag, 2018, 44 (11), pp. 1870-1878. ⟨10.1007/s00134-018-5343-1⟩ |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, Critical Care, HIGH-FLOW NASAL CANNULA, Acute viral bronchiolitis, Critical Care and Intensive Care Medicine, medicine.disease_cause, Intensive Care Units, Pediatric, law.invention, Young infants, NONINVASIVE VENTILATION, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, 030225 pediatrics, medicine, Bronchiolitis, Viral, Cannula, Humans, Prospective Studies, Treatment Failure, BRONCHIOLITIS, Prospective cohort study, business.industry, Infant, Newborn, Oxygen Inhalation Therapy, Infant, medicine.disease, Respiration, Artificial, 3. Good health, 030228 respiratory system, Bronchiolitis, Anesthesia, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, High flow, business, Nasal cannula |
| الوصف: | High-flow nasal cannula (HFNC) therapy is increasingly proposed as first-line respiratory support for infants with acute viral bronchiolitis (AVB). Most teams use 2 L/kg/min, but no study compared different flow rates in this setting. We hypothesized that 3 L/kg/min would be more efficient for the initial management of these patients.A randomized controlled trial was performed in 16 pediatric intensive care units (PICUs) to compare these two flow rates in infants up to 6 months old with moderate to severe AVB and treated with HFNC. The primary endpoint was the percentage of failure within 48 h of randomization, using prespecified criteria of worsening respiratory distress and discomfort.From November 2016 to March 2017, 142 infants were allocated to the 2-L/kg/min (2L) flow rate and 144 to the 3-L/kg/min (3L) flow rate. Failure rate was comparable between groups: 38.7% (2L) vs. 38.9% (3L; p = 0.98). Worsening respiratory distress was the most common cause of failure in both groups: 49% (2L) vs. 39% (3L; p = 0.45). In the 3L group, discomfort was more frequent (43% vs. 16%, p = 0.002) and PICU stays were longer (6.4 vs. 5.3 days, p = 0.048). The intubation rates [2.8% (2L) vs. 6.9% (3L), p = 0.17] and durations of invasive [0.2 (2L) vs. 0.5 (3L) days, p = 0.10] and noninvasive [1.4 (2L) vs. 1.6 (3L) days, p = 0.97] ventilation were comparable. No patient had air leak syndrome or died.In young infants with AVB supported with HFNC, 3 L/kg/min did not reduce the risk of failure compared with 2 L/kg/min. This clinical trial was recorded on the National Library of Medicine registry (NCT02824744). |
| تدمد: | 1432-1238 0282-4744 0342-4642 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8f3335da9df7b12e89619c6f1946087eTest https://pubmed.ncbi.nlm.nih.gov/30483835Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....8f3335da9df7b12e89619c6f1946087e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321238 02824744 03424642 |
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