دورية أكاديمية
Early non-invasive ventilation and high-flow nasal oxygen therapy for preventing endotracheal intubation in hypoxemic blunt chest trauma patients: the OptiTHO randomized trial
| العنوان: | Early non-invasive ventilation and high-flow nasal oxygen therapy for preventing endotracheal intubation in hypoxemic blunt chest trauma patients: the OptiTHO randomized trial |
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| المؤلفون: | Carrié, Cédric, Rieu, Benjamin, Benard, Antoine, Trin, Kilian, Petit, Laurent, Massri, Alexandre, Jurcison, Igor, Rousseau, Guillaume, Tran Van, David, Reynaud Salard, Marie, Bourenne, Jeremy, Levrat, Albrice, Muller, Laurent, Marie, Damien, Dahyot-Fizelier, Claire, Pottecher, Julien, David, Jean-Stéphane, Godet, Thomas, Biais, Matthieu |
| المساهمون: | CHU de Bordeaux Pellegrin Bordeaux, CHU Clermont-Ferrand, CHU Bordeaux, Centre hospitalier de Pau, Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital d'Instruction des Armées Robert Picqué, Service de Santé des Armées, Centre Hospitalier Universitaire de Saint-Etienne CHU Saint-Etienne (CHU ST-E), Hôpital de la Timone CHU - APHM (TIMONE), Centre Hospitalier Annecy-Genevois Saint-Julien-en-Genevois, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie ), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers = University of Poitiers (UP), Centre Hospitalier Universitaire Strasbourg (CHU Strasbourg), Les Hôpitaux Universitaires de Strasbourg (HUS), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Lyon Sud CHU - HCL (CHLS), Hospices Civils de Lyon (HCL), Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
| المصدر: | ISSN: 1364-8535. |
| بيانات النشر: | HAL CCSD BioMed Central |
| سنة النشر: | 2023 |
| المجموعة: | HAL Lyon 1 (University Claude Bernard Lyon 1) |
| مصطلحات موضوعية: | Chest trauma, High-flow nasal oxygen therapy, Intensive care, Non-invasive ventilation, Respiratory failure, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | International audience ; Background The benefit–risk ratio of prophylactic non-invasive ventilation (NIV) and high-flow nasal oxygen therapy (HFNC-O 2 ) during the early stage of blunt chest trauma remains controversial because of limited data. The main objective of this study was to compare the rate of endotracheal intubation between two NIV strategies in high-risk blunt chest trauma patients. Methods The OptiTHO trial was a randomized, open-label, multicenter trial over a two-year period. Every adult patients admitted in intensive care unit within 48 h after a high-risk blunt chest trauma (Thoracic Trauma Severity Score ≥ 8), an estimated PaO 2 /FiO 2 ratio < 300 and no evidence of acute respiratory failure were eligible for study enrollment (Clinical Trial Registration: NCT03943914). The primary objective was to compare the rate of endotracheal intubation for delayed respiratory failure between two NIV strategies: i) a prompt association of HFNC-O 2 and “early” NIV in every patient for at least 48 h with vs. ii) the standard of care associating COT and “late” NIV, indicated in patients with respiratory deterioration and/or PaO 2 /FiO 2 ratio ≤ 200 mmHg. Secondary outcomes were the occurrence of chest trauma-related complications (pulmonary infection, delayed hemothorax or moderate-to-severe ARDS). Results Study enrollment was stopped for futility after a 2-year study period and randomization of 141 patients. Overall, 11 patients (7.8%) required endotracheal intubation for delayed respiratory failure. The rate of endotracheal intubation was not significantly lower in patients treated with the experimental strategy (7% [5/71]) when compared to the control group (8.6% [6/70]), with an adjusted OR = 0.72 (95%IC: 0.20–2.43), p = 0.60 . The occurrence of pulmonary infection, delayed hemothorax or delayed ARDS was not significantly lower in patients treated by the experimental strategy (adjusted OR = 1.99 [95%IC: 0.73–5.89], p = 0.18, 0.85 [95%IC: 0.33–2.20], p = 0.74 and 2.14 [95%IC: 0.36–20.77], p = 0.41 , ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/37101272; hal-04142251; https://hal.science/hal-04142251Test; PUBMED: 37101272; PUBMEDCENTRAL: PMC10131545 |
| DOI: | 10.1186/s13054-023-04429-2 |
| الإتاحة: | https://doi.org/10.1186/s13054-023-04429-2Test https://hal.science/hal-04142251Test |
| رقم الانضمام: | edsbas.17D78570 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s13054-023-04429-2 |
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