ClinicalTrials.gg
CompletedNCT01572337NAVIGATEUpdated Aug 7, 2025

Early Non-invasive Ventilation Outside the Intensive Care Unit

A Phase 4 interventional study of Non-invasive ventilation and Standard care in Early Acute Respiratory Failure, sponsored by Università Vita-Salute San Raffaele. Completed at 14 sites in 3 countries. Open to participants aged 18 Years to 99 Years. Per ClinicalTrials.gov, last updated 2025-08-07.

Sponsored by Università Vita-Salute San Raffaele · Phase 4, Interventional, and Prevention

Phase
Phase 4
Study type
Interventional
Enrollment
520
Allocation
Randomized
Ages
18 Years to 99 Years
Sex
All
01

Study summary

A large multicentre, randomized, controlled trial to demonstrate that non invasive ventilation given at an early stage of acute respiratory failure (ARF) outside the intensive care unit (ICU) can prevent the deterioration of ARF and the need for ICU when compared to the best available treatment usually performed in the non-ICU wards.

02

Conditions studied

  • Early Acute Respiratory Failure

Keywords

  • NIV
  • acute respiratory failure
  • hypoxia
  • hypercapnia
  • non-invasive ventilation
  • hospital ward
03

In context

Hypoxia

1,076 studies on the registry are indexed under Hypoxia; 213 are open to participants now.

This study's enrollment of 520 is above the median of 45 across 769 interventional studies indexed under Hypoxia.

Browse Hypoxia studies →

Lead sponsor

Università Vita-Salute San Raffaele is the lead sponsor of 85 studies on the registry; 33 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 99 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age >= 18 years
  • Admission in a non-intensive-care department
  • Radiological evidence of new pulmonary consolidation or atelectasis
  • Peripheral Oxygen saturation less than 92% while breathing room air or PaO2/FiO2 ratio less than 300 at blood gas analysis
  • Decompensated hypercapnia (pCO2 > 45 mmHg and pH \< 7.35)
  • Clinical signs of respiratory distress (dyspnoea, utilization of accessory respiratory muscles, paradox movements of thoraco-abdominal wall) in air.

Exclusion criteria

Exclusion Criteria:

  • Respiratory failure due to exacerbation, defined as PaCO2 > 45 and pH \< 7.35 (in these patients NIV is considered to be the standard/ treatment and we do not want to deny these patients the opportunity to receive this treatment because of randomization)
  • Severe, hypercapnic ARF defined as PaCO2 > 45 and pH \< 7.30
  • Severe, hypoxic ARF defined as PaO2/FiO2 \< 200
  • Need for immediate mechanical ventilation or ICU as judged by the ICU physician in charge
  • Extremely poor short term prognosis (imminent death with decision for palliative treatment only)
  • Invasive or non-invasive mechanical ventilation during the same hospitalization due to respiratory failure.
  • Clear to NIV treatment: respiratory arrest, failure to correct positioning of a face mask, hemodynamic instability due to hypotensive shock, ongoing myocardial ischemia, arrhythmia, massive bleeding from upper gastrointestinal tract, patient uncooperative and upset, inability to protect airways, alterations of deglutition, inability to clear secretion also with external aspiration, multiple organs dysfunction, recent surgery of airways or upper gastrointestinal tract, not-drained pneumothorax, bowel obstruction, active vomit.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
520 participants (actual)

Study arms

  • Experimental
    NIV

    Non-invasive ventilation

    Procedure: Non-invasive ventilation

  • Other
    Best available treatment

    Other: Standard care

Interventions

  • ProcedureNon-invasive ventilation

    Early non-invasive ventilation will be given to patients at an early stage of acute respiratory failure

    Also known as: Noninvasive ventilation, NIV

  • OtherStandard care
06

What researchers measure

Primary outcomes

  1. Number of patients who will need admission to the Intensive Care Unit care for severe acute respiratory failure

    Time frame: participants will be followed for the duration of hospital stay, an expected average of 2 weeks

07

Study locations

14 sites
  • University of Thessaly
    Larissa, Greece
  • Ospedale San Raffaele di Milano
    Milan, MI 20132, Italy
  • Ospedale Cesare Arrigo
    Alessandria, Piedmont 15121, Italy
  • Ospedale di Novara
    Novara, Piedmont, Italy
  • Ospedale Civile di Asti
    Asti, Italy
  • Spedali Civili
    Brescia, Italy
  • Asl 3 Genovese
    Genova, Italy
  • Ospedali Galliera
    Genova, Italy
  • AOU Pisana
    Pisa, Italy
  • Grande Ospedale Metropolitano
    Reggio Calabria, Italy
  • Aurelia Hospital
    Roma, Italy
  • Policlinico A. Gemelli
    Roma, Italy
  • Azienda Ospedaliera San Giovanni Battista Molinette
    Torino, Italy
  • Astana Medical University
    Kazakhstan, Kazakhstan
08

References and documents

Publications

  • Cabrini L, Nobile L, Plumari VP, Landoni G, Borghi G, Mucchetti M, Zangrillo A. Intraoperative prophylactic and therapeutic non-invasive ventilation: a systematic review. Br J Anaesth. 2014 Apr;112(4):638-47. doi: 10.1093/bja/aet465. Epub 2014 Jan 19. PubMed 24444661 ↗
  • Cabrini L, Plumari VP, Nobile L, Olper L, Pasin L, Bocchino S, Landoni G, Beretta L, Zangrillo A. Non-invasive ventilation in cardiac surgery: a concise review. Heart Lung Vessel. 2013;5(3):137-41. PubMed 24364004 ↗
  • Monti G, Cabrini L, Kotani Y, Brusasco C, Kadralinova A, Giardina G, Chalkias A, Nakhnoukh C, Pantazopoulos I, Oliva FM, Dazzi F, Roasio A, Baiardo Redaelli M, Tripodi VF, Cucciolini G, Belletti A, Vaschetto R, Maj G, Borghi G, Savelli F, Boni S, D'Amico F, Cavallero S, Labanca R, Tresoldi M, Marmiere M, Marzaroli M, Moizo E, Monaco F, Nardelli P, Pieri M, Plumari V, Scandroglio AM, Turi S, Corradi F, Konkayev A, Landoni G, Bellomo R, Zangrillo A; NAVIGATE Study Group. Early noninvasive ventilation in general wards for acute respiratory failure: an international, multicentre, open-label, randomised trial. Br J Anaesth. 2025 Feb;134(2):382-391. doi: 10.1016/j.bja.2024.11.023. Epub 2025 Jan 2. PubMed 39753402 ↗
  • Cabrini L, Brusasco C, Roasio A, Corradi F, Nardelli P, Filippini M, Cotticelli V, Belletti A, Ferrera 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 SSM, Hajjar LA, Zangrillo A, Bellomo R, Landoni G. Non-invAsive VentIlation for early General wArd respiraTory failurE (NAVIGATE): A multicenter randomized controlled study. Protocol and statistical analysis plan. Contemp Clin Trials. 2019 Mar;78:126-132. doi: 10.1016/j.cct.2019.02.001. Epub 2019 Feb 7. PubMed 30739002 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Apr 2012 to primary completion in Aug 2023, 136 months.

Of 17 phase 4 interventional studies under Hypoxia, half reached primary completion within 19 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 47. This study's 136 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 16, 2012
First posted
Apr 6, 2012
StartActual
Apr 2012
Primary completionActual
Aug 17, 2023
CompletionActual
Jul 18, 2024
Last update
Aug 7, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 7, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01572337
Lead sponsor
Università Vita-Salute San Raffaele
Responsible party
Giovanni Landoni (Head of Research, Department of Anesthesiology and Intensive Care, Università Vita-Salute San Raffaele) — Principal investigator
First posted
Apr 6, 2012
Start date
Apr 2012
Primary completion
Aug 17, 2023
Completion
Jul 18, 2024
Last update
Aug 7, 2025
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2025. You cannot join it, but the record below documents what was studied.

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