Objective: Few randomized trials have evaluated the use of non-invasive ventilation (NIV) for early acute respiratory failure (ARF) in non-intensive care unit (ICU) wards. The aim of this study is to test the hypothesis that early NIV for mild-moderate ARF in non-ICU wards can prevent development of severe ARF. Design: Pragmatic, parallel group, randomized, controlled, multicenter trial. Setting: Non-intensive care wards of tertiary centers. Patients: Non-ICU ward patients with mild to moderate ARF without an established indication for NIV. Interventions: Patients will be randomized to receive or not receive NIV in addition to best available care. Measurements and main results: We will enroll 520 patients, 260 in each group. The primary endpoint of the study will be the development of severe ARF. Secondary endpoints will be 28-day mortality, length of hospital stay, safety of NIV in non-ICU environments, and a composite endpoint of all in-hospital respiratory complications. Conclusions: This trial will help determine whether the early use of NIV in non-ICU wards can prevent progression from mild-moderate ARF to severe ARF.

Non-invAsive VentIlation for early General wArd respiraTory failurE (NAVIGATE): A multicenter randomized controlled study. Protocol and statistical analysis plan

Cabrini L.;
2019-01-01

Abstract

Objective: Few randomized trials have evaluated the use of non-invasive ventilation (NIV) for early acute respiratory failure (ARF) in non-intensive care unit (ICU) wards. The aim of this study is to test the hypothesis that early NIV for mild-moderate ARF in non-ICU wards can prevent development of severe ARF. Design: Pragmatic, parallel group, randomized, controlled, multicenter trial. Setting: Non-intensive care wards of tertiary centers. Patients: Non-ICU ward patients with mild to moderate ARF without an established indication for NIV. Interventions: Patients will be randomized to receive or not receive NIV in addition to best available care. Measurements and main results: We will enroll 520 patients, 260 in each group. The primary endpoint of the study will be the development of severe ARF. Secondary endpoints will be 28-day mortality, length of hospital stay, safety of NIV in non-ICU environments, and a composite endpoint of all in-hospital respiratory complications. Conclusions: This trial will help determine whether the early use of NIV in non-ICU wards can prevent progression from mild-moderate ARF to severe ARF.
2019
Acute respiratory failure; ARF; NIV; Non-invasive ventilation
Cabrini, L.; Brusasco, C.; Roasio, A.; Corradi, F.; Nardelli, P.; Filippini, M.; Cotticelli, V.; Belletti, A.; Ferrara, L.; Antonucci, E.; Baiardo Redaelli, M.; Lattuada, M.; Colombo, S.; Olper, L.; Ponzetta, G.; Ananiadou, S.; Monti, G.; Severi, L.; Maj, G.; Giardina, G.; Biondi-Zoccai, G.; Benedetto, U.; Gemma, M.; Cavallero, S. S. M.; Hajjar, L. A.; Zangrillo, A.; Bellomo, R.; Landoni, G.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2087508
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