End Tidal Carbon Dioxide Monitoring for Evaluating Changes of PaCO2 After Noninvasive Mechanical Ventilation in COPD

NCT ID: NCT01821365

Last Updated: 2013-04-05

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 40 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2013-03-31
• Study Completion Date: 2013-07-31

Brief Summary

Sidestream end-tidal CO2 has been found to be closely correlated to PaCO2 especially when people have the stable hemodynamics and normal lung function. PETCO2 can basically reflect the level of PaCO2,but some investigators found that PETCO2 measurements did not reflect PaCO2 in COPD patients.There may be several reasons for this discrepancy. Due to airway obstruction and ventilation-perfusion mismatch, there is a delay in the maximum alveolar concentration of CO2 reaching the cannula, which may give lower PETCO2 values compared with PaCO2. To overcome this disadvantage, we tried to prolong their expiratory time (extend to 5-8s) in order to guarantee adequate time for alveolar CO2 reaching the cannula.our study mainly focus on two issues.First, to explore the optimal depth of tube placed when patients with COPD breathe spontaneously or receive noninvasive ventilation, and compare the differences of two condition at the same time. Secondly, to evaluate the agreement between the PaCO2 and sidestream PETCO2（5s）values in COPD patients receiving noninvasive ventilation when our extension tube locates in the optimal position, and investigate whether PETCO2（5s）can be used to monitor ventilation status dynamically.

Detailed Description

Non-invasive positive pressure ventilation(NPPV) can significantly improve gas exchange and relieve respiratory muscle fatigue for COPD,and arterial blood gas is the gold standard to evaluate ventilation status,but the procedure is time consuming,invasive, painful and in some patients.

Sidestream end-tidal CO2 has been found to be closely correlated to PaCO2 especially when people have the stable hemodynamics and normal lung function. PETCO2 can basically reflect the level of PaCO2, but for patients with COPD, due to the presence of airway obstruction and emphysema formation, which cause ventilation-perfusion ratio(V/Q) , result to dead space-tidal volume ratio(VD/VT) and right-to-left shunting(Qs/Qt), the time of various lung units discharge of carbon dioxide is not synchronous. Some investigators found that PETCO2 measurements did not reflect PaCO2 in COPD patients. There may be several reasons for this discrepancy. Due to airway obstruction and ventilation-perfusion mismatch, there is a delay in the maximum alveolar concentration of CO2 reaching the cannula, which may give lower PETCO2 values compared with PaCO2. To overcome this disadvantage, we tried to prolong their expiratory time (extend to 5-8s) in order to guarantee adequate time for alveolar CO2 reaching the cannula.

our study mainly focus on two issues.First, to explore the optimal depth of tube placed when patients with COPD breathe spontaneously or receive noninvasive ventilation, and compare the differences of two condition at the same time. Secondly, to evaluate the agreement between the PaCO2 and sidestream PETCO2（5s）values in COPD patients receiving noninvasive ventilation when our extension tube locates in the optimal position, and investigate whether PETCO2（5s）can be used to monitor ventilation status dynamically.

Conditions

COPD

Study Design

• Study Time Perspective: PROSPECTIVE

Eligibility Criteria

Inclusion Criteria

2.patients are in a clear state of mind and can incompliance with clinicians to extend breathing only using nose and closing mouth.

Exclusion Criteria

3.combinating acute exacerbation of bronchial asthma in this hospitalization. 4.Nose and mouth trauma, deformity, or recent surgery.

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 85 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

The First Affiliated Hospital of Guangzhou Medical University

OTHER

Sponsor Role: lead

Responsible Party

ting Jiang

MM

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Rongchang Chen, MD

Role: PRINCIPAL_INVESTIGATOR

The First Affiliated Hospital of Guangzhou Medical University

Locations

The First Affiliated Hospital of Guangzhou Medical University

Guangzhou, Guangdong, China

Site Status: RECRUITING

Countries

China

Central Contacts

rongchang Chen, MD

Role: CONTACT

Chenrc99@163.com

020-83062718

Facility Contacts

Rongchang Chen, MD

Role: primary

Chenrc99@163.com

020-83062718

References

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Reference Type: BACKGROUND

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Reference Type: RESULT

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Reference Type: RESULT

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Lopez E, Grabar S, Barbier A, Krauss B, Jarreau PH, Moriette G. Detection of carbon dioxide thresholds using low-flow sidestream capnography in ventilated preterm infants. Intensive Care Med. 2009 Nov;35(11):1942-9. doi: 10.1007/s00134-009-1647-5.

Reference Type: RESULT

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Cinar O, Acar YA, Arziman I, Kilic E, Eyi YE, Ocal R. Can mainstream end-tidal carbon dioxide measurement accurately predict the arterial carbon dioxide level of patients with acute dyspnea in ED. Am J Emerg Med. 2012 Feb;30(2):358-61. doi: 10.1016/j.ajem.2010.12.014. Epub 2011 Jan 28.

Reference Type: RESULT

PMID: 21277140 (View on PubMed)

Howe TA, Jaalam K, Ahmad R, Sheng CK, Nik Ab Rahman NH. The use of end-tidal capnography to monitor non-intubated patients presenting with acute exacerbation of asthma in the emergency department. J Emerg Med. 2011 Dec;41(6):581-9. doi: 10.1016/j.jemermed.2008.10.017. Epub 2009 Mar 9.

Reference Type: RESULT

PMID: 19272745 (View on PubMed)

Other Identifiers

2009CB522100

Identifier Type: -

Identifier Source: org_study_id