Efficacy and Physiology of Nasal High Flow Therapy

NCT ID: NCT02083120

Last Updated: 2019-02-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

46 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2018-11-01

Brief Summary

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The effects of a nasal high-flow (NHF) therapy in patients with chronic obstructive hypercapnic respiratory failure are still not sufficiently known yet.

The aim of this study is a step-by-step generation of physiological data about gas exchange and respiration under high flow therapy using a nasal cannula with an AIRVO 2 device to provide NHF, leading to an analysis of the effects of high flow on PCO2 levels, exercise capacity, quality of life and gas exchange in a long term home treatment compared to a standard low flow long term oxygen therapy (LOT).

Hypothesis: NHF and LOT therapy show differences in measured mean overnight transcutaneous carbon dioxide partial pressure (PCO2) after four weeks of treatment.

Detailed Description

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Stage 1: Respiratory Physiology. Aim of this Stage is to investigate the effects of nasal High Flow (NHF) therapy in patients in progressed stages of COPD, by measuring physiologic parameters like tidal volume, breathing frequency and expiratory PCO2 concentration.

Stage 2: Efficacy of short term NHF. Aim of this Stage is to evaluate the efficacy of two flow rates (20 L/min and 35 L/min) regarding alveolar ventilation in overnight therapy. For this reason, patients will have two PSG sleep studies during their hospital stay, under 20 L/min and 35 L/min NHF therapy in randomized order.

Stage 3: Home Care monitoring. Aim of this Stage is to compare long term influences of NHF and LOT on PCO2 levels randomised crossover, 4 weeks each treatment.

Stage 4: Long Term Home Care monitoring . Aim of this stage is the long term follow up (12 month) of patients to examine the compliance of a sufficient NHF therapy. Patients will retain the NHF therapy if they are responders (PCO2 improvement in stage 3 of at least 2 mmHG with NHF versus LOT) and willing and able to use NHF and a patient log.

All patients will be monitored for the next 12 month. After 6 month there will be a control phone call.

Conditions

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Pulmonary Disease, Chronic Obstructive

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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nasal High Flow and Oxygen

overnight nasal High Flow (NHF) therapy+ individually titrated supplemental oxygen (2-6 L/min),total 35 L/min, 4 weeks at home

Group Type EXPERIMENTAL

NHF therapy

Intervention Type DEVICE

AIRVO 2 device therapy is either a humidifier with integrated flow generator that delivers warmed and humidified respiratory gases to spontaneously breathing patients through a variety of patient interfaces. Flow rates up to 60 L/min are available to the user, depending on the patient interface and mode of operation.In this study, flow rates of 20 L/min and 35 L/min will be compared.

Long term Oxygen Therapy (LOT)

Intervention Type OTHER

Oxygen will individually be added to NHF in order to achieve stable oxygen saturation by pulse oximetry (SpO2) values of 88% to 92%.

Long term Oxygen Therapy (LOT)

individually titrated supplemental oxygen (2-6 L/min), 4 weeks at home

Group Type ACTIVE_COMPARATOR

Long term Oxygen Therapy (LOT)

Intervention Type OTHER

Oxygen will individually be added to NHF in order to achieve stable oxygen saturation by pulse oximetry (SpO2) values of 88% to 92%.

Interventions

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NHF therapy

AIRVO 2 device therapy is either a humidifier with integrated flow generator that delivers warmed and humidified respiratory gases to spontaneously breathing patients through a variety of patient interfaces. Flow rates up to 60 L/min are available to the user, depending on the patient interface and mode of operation.In this study, flow rates of 20 L/min and 35 L/min will be compared.

Intervention Type DEVICE

Long term Oxygen Therapy (LOT)

Oxygen will individually be added to NHF in order to achieve stable oxygen saturation by pulse oximetry (SpO2) values of 88% to 92%.

Intervention Type OTHER

Other Intervention Names

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AIRVO 2 myAIRVO 2 PT101 PT100 supplemental oxygen

Eligibility Criteria

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Inclusion Criteria

* Age 40-80
* Male and female
* COPD patients with chronic respiratory insufficiency (pH \>7.35 and PCO2 \> 50mmHg)
* Stable respiratory situation

Exclusion Criteria

* Decompensated heart, liver or kidney failure.
* Pregnancy or nursing period
* Participation in another clinical trial within the last 4 weeks
* Drug abuse
* Incapable of giving consent
* Known obstructive sleep apnea syndrome (OSA) (AHI\>10)
* noninvasive ventilation (NIV) therapy
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fisher and Paykel Healthcare

INDUSTRY

Sponsor Role collaborator

Institut für Pneumologie Hagen Ambrock eV

INDUSTRY

Sponsor Role lead

Responsible Party

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Georg Nilius

Head of pneumologic department of Helios Klinik Hagen

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Georg Nilius, MD

Role: PRINCIPAL_INVESTIGATOR

Helios Klinik Ambrock

Locations

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Helios Klinik Ambrock

Hagen, North Rhine-Westphalia, Germany

Site Status

Countries

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Germany

Other Identifiers

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AIRVOhome

Identifier Type: -

Identifier Source: org_study_id

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