Étude FLORALI (High-FLow Oxygen Therapy for the Resuscitation of Acute Lung Injury): intérêt de l’oxygénothérapie nasale humidifiée et réchauffée à ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-01

AUTHORS

J. -P. Frat, A. Thille, C. Girault, S. Ragot, REVA: Réseau européen de recherche en ventilation artificielle

ABSTRACT

L’intérêt de la ventilation non invasive (VNI) dans la prise en charge de la pneumopathie hypoxémiante du sujet immunocompétent est controversé, avec un taux d’échec aboutissant à une intubation trachéale dans environ 60 % des cas. L’oxygénothérapie à haut débit nasale avec humidification (O2-HDN) est une nouvelle technique assurant une FiO2 élevée et une pression expiratoire positive. L’étude FLORALI a pour but d’évaluer l’utilisation de l’O2-HDN dans l’insuffisance respiratoire aiguë (IRA) hypoxémique, seule, associée à la VNI ou comparativement à l’oxygénothérapie conventionnelle. Patients et méthode: Cette étude multicentrique, randomisée, ouverte, contrôlée a pour but de comparer trois stratégies d’oxygénation dans la prise en charge précoce et non invasive de l’IRA hypoxémique non hypercapnique: l’association VNI/O2-HDN, l’O2-HDN seule et l’O2 seule. Les patients sont inclus si les critères suivants sont réunis: dyspnée de repos sévère avec mise en jeu des muscles respiratoires accessoires, fréquence respiratoire supérieure ou égale à 25 cycles par minute, PaO2/FiO2 inférieur ou égal à 300 mmHg sous O2 au masque à haute concentration et PaCO2 inférieure ou égale à 45 mmHg. L’objectif principal est de montrer une réduction significative du taux d’intubation dans les groupes traités selon une stratégie comprenant l’O2-HDN. Ainsi, 300 patients sont nécessaires pour mettre en évidence une différence absolue de 20 % entre les deux groupes. On estime, en effet, à 60 % le recours à la ventilation invasive dans le groupe O2 et l’on souhaite montrer qu’elle n’est que de 40 % dans les groupes O2-HDN et VNI/O2-HDN. Cette étude bénéficie du soutien du Réseau européen de recherche en ventilation artificielle (REVA). More... »

PAGES

90-99

Journal

TITLE

Médecine Intensive Réanimation

ISSUE

1

VOLUME

22

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s13546-012-0527-4

DOI

http://dx.doi.org/10.1007/s13546-012-0527-4

DIMENSIONS

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