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Respiratory Distress Syndrome, AdultGLAMOURNCT06489379

High Flow Nasal Oxygen for Acute Hypoxemic Respiratory Failure in the Emergency Room

A study testing high flow nasal cannula and standard oxygen in people with Respiratory Distress Syndrome, Adult, run by Fondazione Policlinico Universitario Agostino Gemelli IRCCS.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The aim of this multicenter, randomized, controlled, open-label trial is to investigate the efficacy of early treatment with HFNO compared with SOT in preventing early deterioration of patients admitted to the ER because of acute hypoxemic respiratory failure. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Respiratory Distress Syndrome, Adult
What is being tested?
high flow nasal cannula and standard oxygen
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
234 participants
Where
No sites listed yet
Study dates
Jul 2024to Jul 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years;
  • PaO2/FiO2 ratio between 250 and 150 mmHg or SpO2/FiO2 ratio between 190 and 274, after at least 15 minutes of spontaneous breathing through a Venturi mask (VM), with a FiO2 targeted at a SpO2 94-97%;
  • Respiratory rate(RR)≤35breaths/min,afteratleast15minutesofspontaneous breathing through a VM, with a FiO2 targeted at a SpO2 94-97%;
  • PaCO2 ≤ 45 mmHg;
  • Unilateral or bilateral infiltrate(s), as detected with chest radiography and/or computed tomography and/or with lung ultrasound not fully explained by effusions, atelectasis, or nodules/masses. Infiltrates at lung ultrasound are defined as presence of focal B-lines, consolidations (with irregular marginal contour, air bronchogram, air trapping sign) and irregularity of the pleural line.

Who cannot join

  • Respiratory failure due to:
  • Acute asthma or COPD exacerbation,
  • Cardiac failure or fluid overload as primary cause of respiratory failure;
  • Unstable angina or ongoing acute myocardial infarction;
  • Acute respiratory acidosis with pH < 7.35 and PaCO2 > 45 mmHg;
  • Hemodynamic instability and/or use of vasopressors/inotropes;
Show all 12Show fewer
  • Altered mental status (Kelly >3), see Figure 1;(18)
  • Contraindications to NIV (high risk of aspiration pneumonia, impaired airways protection, head-facial trauma and/or burns, uncooperative patient, cranial/thoracic/abdominal open wounds);
  • Indications to urgent intubation performed according to the clinician in charge;
  • Body Mass Index > 35 kg/m2;
  • Pregnancy;
  • Patient's refusal to participate.

Trial locations and contacts

No sites are listed yet.

About this study

Official title: High Flow Nasal Oxygen for Acute Hypoxemic Respiratory Failure in the Emergency Room: the GLAMOUR Study

The aim of this multicenter, randomized, controlled, open-label trial is to investigate the efficacy of early treatment with HFNO compared with SOT in preventing early deterioration of patients admitted to the ER because of acute hypoxemic respiratory failure.

Being tested
high flow nasal cannula, standard oxygen
Medical subject headings
Respiratory Distress Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • high flow nasal cannulaDevice

    humidified and heated oxygen

  • standard oxygenOther

    oxygen delivery through Venturi mask

Study groups in NCT06489379
Study groupRoleWhat they receive
standard oxygenActive comparatorNot described
Receives: Other: standard oxygen
high flow nasal oxygenExperimentalNot described
Receives: Device: high flow nasal cannula

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Early deterioration

    occurrence of any of the following from randomization: respiratory worsening; respiratory acidosis; severe respiratory distress; start of non-invasive ventilation; necessity of endotracheal intubation; development of shock; death.

    Measured: 24 hours

Secondary outcomes (15)
  1. Development of respiratory acidosis

    arterial pH

    Measured: 2, 12 and 24 hours

  2. Development of hypercapnia

    arterial pCO2

    Measured: 2, 12 and 24 hours

  3. Worsening hypoxemia

    P/F ratio

    Measured: 2, 12 and 24 hours

  4. Worsening respiratory distress

    respiratory frequency

    Measured: 2, 12 and 24 hours

  5. duration of any type of ventilatory support

    hours of ventilatory support

    Measured: 90 days

  6. rate of ICU admission

    number of patients admitted to ICU

    Measured: 90 days

  7. hospital length-of-stay

    duration of hospitalization

    Measured: 30 days

  8. in-hospital mortality

    death during hospitalization

    Measured: 90 days

  9. ICU length-of-stay

    duration of ICU stay

    Measured: 90 days

  10. ICU mortality

    death in ICU

    Measured: 90 days

  11. development of complications

    composite outcome of septic shock, nosocomial pneumonia, cardiac arrhythmia, cardiac arrest, delirium

    Measured: 90 days

  12. level of dyspnea

    utilizing Borg scale

    Measured: 24 hours

  13. patient comfort

    utilizing visual analogue scale

    Measured: 24 hours

  14. clinical setting after ED stabilization

    type of ward admission

    Measured: 24 hours

  15. standard vs asymmetrical high-flow nasal cannula

    rate of early deterioration in the treatment group will be compared between patients treated with standard or asymmetrical high-flow nasal cannula

    Measured: 24 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jul 2024
  2. Study startJul 2024 (estimated)
  3. Primary completionJul 2025 (estimated)
  4. Study completionJul 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
234 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06489379
Sponsor's protocol ID
6697
Acronym
GLAMOUR
Status last verified
Jul 2024
First submitted
21 Jun 2024
Last updated
5 Jul 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided

Publications

  • Raveling T, Vonk J, Struik FM, Goldstein R, Kerstjens HA, Wijkstra PJ, Duiverman ML. Chronic non-invasive ventilation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2021 Aug 9;8(8):CD002878. doi: 10.1002/14651858.CD002878.pub3.

    PubMed 34368950
  • Berbenetz N, Wang Y, Brown J, Godfrey C, Ahmad M, Vital FM, Lambiase P, Banerjee A, Bakhai A, Chong M. Non-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane Database Syst Rev. 2019 Apr 5;4(4):CD005351. doi: 10.1002/14651858.CD005351.pub4.

    PubMed 30950507
  • Rochwerg B, Brochard L, Elliott MW, Hess D, Hill NS, Nava S, Navalesi P Members Of The Steering Committee, Antonelli M, Brozek J, Conti G, Ferrer M, Guntupalli K, Jaber S, Keenan S, Mancebo J, Mehta S, Raoof S Members Of The Task Force. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017 Aug 31;50(2):1602426. doi: 10.1183/13993003.02426-2016. Print 2017 Aug.

    PubMed 28860265
  • Antonelli M, Conti G, Esquinas A, Montini L, Maggiore SM, Bello G, Rocco M, Maviglia R, Pennisi MA, Gonzalez-Diaz G, Meduri GU. A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome. Crit Care Med. 2007 Jan;35(1):18-25. doi: 10.1097/01.CCM.0000251821.44259.F3.

    PubMed 17133177
  • Carteaux G, Millan-Guilarte T, De Prost N, Razazi K, Abid S, Thille AW, Schortgen F, Brochard L, Brun-Buisson C, Mekontso Dessap A. Failure of Noninvasive Ventilation for De Novo Acute Hypoxemic Respiratory Failure: Role of Tidal Volume. Crit Care Med. 2016 Feb;44(2):282-90. doi: 10.1097/CCM.0000000000001379.

    PubMed 26584191
  • Bellani G, Laffey JG, Pham T, Madotto F, Fan E, Brochard L, Esteban A, Gattinoni L, Bumbasirevic V, Piquilloud L, van Haren F, Larsson A, McAuley DF, Bauer PR, Arabi YM, Ranieri M, Antonelli M, Rubenfeld GD, Thompson BT, Wrigge H, Slutsky AS, Pesenti A; LUNG SAFE Investigators; ESICM Trials Group. Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome. Insights from the LUNG SAFE Study. Am J Respir Crit Care Med. 2017 Jan 1;195(1):67-77. doi: 10.1164/rccm.201606-1306OC.

    PubMed 27753501
  • Demoule A, Girou E, Richard JC, Taille S, Brochard L. Benefits and risks of success or failure of noninvasive ventilation. Intensive Care Med. 2006 Nov;32(11):1756-65. doi: 10.1007/s00134-006-0324-1. Epub 2006 Sep 21.

    PubMed 17019559
  • Marjanovic N, Guenezan J, Frat JP, Mimoz O, Thille AW. High-flow nasal cannula oxygen therapy in acute respiratory failure at Emergency Departments: A systematic review. Am J Emerg Med. 2020 Jul;38(7):1508-1514. doi: 10.1016/j.ajem.2020.04.091. Epub 2020 May 4.

    PubMed 32389397
  • Roca O, Riera J, Torres F, Masclans JR. High-flow oxygen therapy in acute respiratory failure. Respir Care. 2010 Apr;55(4):408-13.

    PubMed 20406507
  • Oczkowski S, Ergan B, Bos L, Chatwin M, Ferrer M, Gregoretti C, Heunks L, Frat JP, Longhini F, Nava S, Navalesi P, Ozsancak Ugurlu A, Pisani L, Renda T, Thille AW, Winck JC, Windisch W, Tonia T, Boyd J, Sotgiu G, Scala R. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure. Eur Respir J. 2022 Apr 14;59(4):2101574. doi: 10.1183/13993003.01574-2021. Print 2022 Apr.

    PubMed 34649974
  • Chidekel A, Zhu Y, Wang J, Mosko JJ, Rodriguez E, Shaffer TH. The effects of gas humidification with high-flow nasal cannula on cultured human airway epithelial cells. Pulm Med. 2012;2012:380686. doi: 10.1155/2012/380686. Epub 2012 Sep 3.

    PubMed 22988501
  • Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, Prat G, Boulain T, Morawiec E, Cottereau A, Devaquet J, Nseir S, Razazi K, Mira JP, Argaud L, Chakarian JC, Ricard JD, Wittebole X, Chevalier S, Herbland A, Fartoukh M, Constantin JM, Tonnelier JM, Pierrot M, Mathonnet A, Beduneau G, Deletage-Metreau C, Richard JC, Brochard L, Robert R; FLORALI Study Group; REVA Network. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med. 2015 Jun 4;372(23):2185-96. doi: 10.1056/NEJMoa1503326. Epub 2015 May 17.

    PubMed 25981908
  • Tinelli V, Cabrini L, Fominskiy E, Franchini S, Ferrante L, Ball L, Pelosi P, Landoni G, Zangrillo A, Secchi A. High Flow Nasal Cannula Oxygen vs. Conventional Oxygen Therapy and Noninvasive Ventilation in Emergency Department Patients: A Systematic Review and Meta-Analysis. J Emerg Med. 2019 Sep;57(3):322-328. doi: 10.1016/j.jemermed.2019.06.033. Epub 2019 Aug 14.

    PubMed 31421952
  • Rochwerg B, Granton D, Wang DX, Helviz Y, Einav S, Frat JP, Mekontso-Dessap A, Schreiber A, Azoulay E, Mercat A, Demoule A, Lemiale V, Pesenti A, Riviello ED, Mauri T, Mancebo J, Brochard L, Burns K. High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: a systematic review and meta-analysis. Intensive Care Med. 2019 May;45(5):563-572. doi: 10.1007/s00134-019-05590-5. Epub 2019 Mar 19.

    PubMed 30888444
  • Matthay MA, Arabi Y, Arroliga AC, Bernard G, Bersten AD, Brochard LJ, Calfee CS, Combes A, Daniel BM, Ferguson ND, Gong MN, Gotts JE, Herridge MS, Laffey JG, Liu KD, Machado FR, Martin TR, McAuley DF, Mercat A, Moss M, Mularski RA, Pesenti A, Qiu H, Ramakrishnan N, Ranieri VM, Riviello ED, Rubin E, Slutsky AS, Thompson BT, Twagirumugabe T, Ware LB, Wick KD. A New Global Definition of Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2024 Jan 1;209(1):37-47. doi: 10.1164/rccm.202303-0558WS.

    PubMed 37487152

Questions about this trial

What is this clinical trial studying?

A study testing high flow nasal cannula and standard oxygen in people with Respiratory Distress Syndrome, Adult, run by Fondazione Policlinico Universitario Agostino Gemelli IRCCS.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 5 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Francesco Franceschi, MD (+390630156627, francesco.franceschi@policlinicogemelli.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Early deterioration (time frame: 24 hours). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06489379, which also lists 26 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Jul 2024.

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