Heliox-Powered Albuterol Therapy in the Treatment of Children Admitted With Acute Asthma Exacerbation

NCT ID: NCT00410150

Last Updated: 2010-11-08

Study Results

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-04-30

Study Completion Date

2007-12-31

Brief Summary

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The purpose of this study is to investigate whether heliox-powered albuterol nebulizer therapy will result in reduced inpatient length of stay in children hospitalized with acute asthma exacerbations.

Detailed Description

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We hypothesize that heliox-powered albuterol nebulizer therapy will result in reduced inpatient length of stay in children hospitalized with acute asthma exacerbations. Severity of asthma will be characterized using a modified Becker Clinical Asthma Score (CAS) based upon the acuity of physical signs for four clinical characteristics (respiratory rate, wheezing, I/E ratio, and accessory muscle use). Scoring will occur at the time of enrollment and every 4 hours thereafter until the patient meets hospital discharge criteria. All scoring using the CAS will be performed by an independent physician, nurse or respiratory therapist blinded to the subject treatment arm. All children will receive standard cardiopulmonary monitoring and treatment, consisting of supplemental oxygen delivered as needed by either nasal cannula or face mask to maintain oxygen saturation \>90%, maintenance intravenous fluids, corticosteroid therapy and nebulized albuterol therapy. After written informed consent, eligible children will be randomized to one of two study groups using a sealed envelope technique:

Group 1 (Heliox-Powered Albuterol) patients will receive all albuterol nebulizer treatments, including continuous therapy, powered by 70:30 Heliox.

Group 2 (Oxygen-Powered Albuterol) patients will receive all albuterol nebulizer treatments, including continuous therapy, powered by 100% oxygen per usual standard of care.

Conditions

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Status Asthmaticus

Keywords

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Status asthmaticus Asthma Helium Children

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Group 1 (Heliox-powered albuterol)

Group 1 (Heliox-Powered Albuterol) patients will receive all albuterol nebulizer treatments, including continuous therapy, powered by 70:30 Heliox.

Group Type EXPERIMENTAL

Helium-oxygen-driven albuterol nebulizer

Intervention Type DRUG

Subjects will be treated with continuous albuterol nebs with Heliox

Group 2 (Oxygen-powered albuterol)

Group 2 (Oxygen-Powered Albuterol) patients will receive all albuterol nebulizer treatments, including continuous therapy, powered by 100% oxygen per usual standard of care.

Group Type ACTIVE_COMPARATOR

Oxygen

Intervention Type DRUG

Subjects will be treated with continuous albuterol nebs in oxygen

Interventions

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Helium-oxygen-driven albuterol nebulizer

Subjects will be treated with continuous albuterol nebs with Heliox

Intervention Type DRUG

Oxygen

Subjects will be treated with continuous albuterol nebs in oxygen

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age 2 -18 years;
* Previous history of asthma;
* Hospital admission for acute asthma exacerbation;
* Clinical asthma score greater than or equal to 3

Exclusion Criteria

* Less than 2 years old or over 18 years old;
* Known allergy or hypersensitivity to ß-agonists;
* Require mechanical ventilation (invasive or non-invasive);
* Require FiO2 \>0.4;
* Failure to obtain informed consent;
* Enrollment in another investigational drug or asthma protocol;
* Incipient respiratory failure including but limited to respiratory acidosis(pCO2\>60 torr), altered mental status and/or excessive work of breathing.
Minimum Eligible Age

24 Months

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Children's Hospital Medical Center, Cincinnati

OTHER

Sponsor Role lead

Responsible Party

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Cincinnati Children's Hospital Medical Center

Principal Investigators

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Derek S Wheeler, M.D.

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital Medical Center, Cincinnati

Locations

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Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Site Status

Countries

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United States

References

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Rivera ML, Kim TY, Stewart GM, Minasyan L, Brown L. Albuterol nebulized in heliox in the initial ED treatment of pediatric asthma: a blinded, randomized controlled trial. Am J Emerg Med. 2006 Jan;24(1):38-42. doi: 10.1016/j.ajem.2005.06.007.

Reference Type BACKGROUND
PMID: 16338507 (View on PubMed)

Kim IK, Phrampus E, Venkataraman S, Pitetti R, Saville A, Corcoran T, Gracely E, Funt N, Thompson A. Helium/oxygen-driven albuterol nebulization in the treatment of children with moderate to severe asthma exacerbations: a randomized, controlled trial. Pediatrics. 2005 Nov;116(5):1127-33. doi: 10.1542/peds.2004-2136.

Reference Type BACKGROUND
PMID: 16263999 (View on PubMed)

Bandi V, Velamuri S, Sirgi C, Wendt J, Wendt R, Guntupalli K. Deposition pattern of heliox-driven bronchodilator aerosol in the airways of stable asthmatics. J Asthma. 2005 Sep;42(7):583-6. doi: 10.1080/02770900500216135.

Reference Type BACKGROUND
PMID: 16169793 (View on PubMed)

Lee DL, Hsu CW, Lee H, Chang HW, Huang YC. Beneficial effects of albuterol therapy driven by heliox versus by oxygen in severe asthma exacerbation. Acad Emerg Med. 2005 Sep;12(9):820-7. doi: 10.1197/j.aem.2005.04.020.

Reference Type BACKGROUND
PMID: 16141015 (View on PubMed)

Ho AM, Lee A, Karmakar MK, Dion PW, Chung DC, Contardi LH. Heliox vs air-oxygen mixtures for the treatment of patients with acute asthma: a systematic overview. Chest. 2003 Mar;123(3):882-90. doi: 10.1378/chest.123.3.882.

Reference Type BACKGROUND
PMID: 12628892 (View on PubMed)

Kress JP, Noth I, Gehlbach BK, Barman N, Pohlman AS, Miller A, Morgan S, Hall JB. The utility of albuterol nebulized with heliox during acute asthma exacerbations. Am J Respir Crit Care Med. 2002 May 1;165(9):1317-21. doi: 10.1164/rccm.9907035.

Reference Type BACKGROUND
PMID: 11991886 (View on PubMed)

Haynes JM, Sargent RJ, Sweeney EL. Use of heliox to avoid intubation in a child with acute severe asthma and hypercapnia. Am J Crit Care. 2003 Jan;12(1):28-30. No abstract available.

Reference Type BACKGROUND
PMID: 12526234 (View on PubMed)

Rose JS, Panacek EA, Miller P. Prospective randomized trial of heliox-driven continuous nebulizers in the treatment of asthma in the emergency department. J Emerg Med. 2002 Feb;22(2):133-7. doi: 10.1016/s0736-4679(01)00454-1.

Reference Type BACKGROUND
PMID: 11858916 (View on PubMed)

Dorfman TA, Shipley ER, Burton JH, Jones P, Mette SA. Inhaled heliox does not benefit ED patients with moderate to severe asthma. Am J Emerg Med. 2000 Jul;18(4):495-7. doi: 10.1053/ajem.2000.7365. No abstract available.

Reference Type BACKGROUND
PMID: 10919545 (View on PubMed)

Schaeffer EM, Pohlman A, Morgan S, Hall JB. Oxygenation in status asthmaticus improves during ventilation with helium-oxygen. Crit Care Med. 1999 Dec;27(12):2666-70. doi: 10.1097/00003246-199912000-00010.

Reference Type BACKGROUND
PMID: 10628607 (View on PubMed)

Kass JE, Terregino CA. The effect of heliox in acute severe asthma: a randomized controlled trial. Chest. 1999 Aug;116(2):296-300. doi: 10.1378/chest.116.2.296.

Reference Type BACKGROUND
PMID: 10453854 (View on PubMed)

Henderson SO, Acharya P, Kilaghbian T, Perez J, Korn CS, Chan LS. Use of heliox-driven nebulizer therapy in the treatment of acute asthma. Ann Emerg Med. 1999 Feb;33(2):141-6. doi: 10.1016/s0196-0644(99)70386-0.

Reference Type BACKGROUND
PMID: 9922408 (View on PubMed)

Kudukis TM, Manthous CA, Schmidt GA, Hall JB, Wylam ME. Inhaled helium-oxygen revisited: effect of inhaled helium-oxygen during the treatment of status asthmaticus in children. J Pediatr. 1997 Feb;130(2):217-24. doi: 10.1016/s0022-3476(97)70346-9.

Reference Type BACKGROUND
PMID: 9042123 (View on PubMed)

Related Links

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http://www.cincinnatichildrens.org

Cincinnati Children's Hospital Medical Center

Other Identifiers

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05-11-34-74-067

Identifier Type: -

Identifier Source: org_study_id