Makerere University: A multicentre, prospective, randomized, open label, stepped wedge clinical trial of respiratory support with standard low flow oxygen therapy, frugal continuous positive airway pressure, and high-flow oxygen therapy in acute resp

Much of critical care revolves around respiratory support. Indeed, AHRF contributes the highest proportion of intensive care admissions worldwide. Therefore, any strategy to optimise critical care in Africa begins with care of the patient with Acute Hypoxemic Respiratory Failure. This study provides an opportunity to introduce a cost-effective intervention that would also constitute a significant component of holistic frugal critical care in Africa. This study is a pilot in the following manner, in addition to answering the primary question of which intervention is suitable, it will provide insights to the logistics of applying such interventions in places with under-staffed healthcare workers. In addition, use role of newer and safer lung diagnostics such as lung ultrasound shall be employed to ensure quicker diagnosis and to assist in patient stratification. These answers shall inform preparations for larger multi-country trials that will test the efficacy of either one of the interventions (BREATHE) or their combination (COSTA). This is also likely to be the first adult acute respiratory trials network in sub-Saharan Africa. This work has the potential to impact care of the critically ill patient in Africa.

Programme: Innovations LMIC Flagship

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