Auto-titrating Oxygen in Chronic Respiratory Failure

NCT ID: NCT02248064

Last Updated: 2023-11-28

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

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-31

Study Completion Date

2015-11-30

Brief Summary

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Long term oxygen therapy (LTOT) increases the life span of patients with chronic obstructive pulmonary disease who have low oxygen levels. However, even when on oxygen therapy at home, from time to time patients still have low oxygen levels especially when walking which can be harmful.

The investigators have designed a new system of delivering oxygen to overcome the above problem. The system measures the oxygen saturations of a patient and subsequently adjust the flow of oxygen to meet a pre-set oxygen saturation target.

Hypothesis: the investigators intelligent oxygen therapy system is better at reducing low levels of oxygen during a 6 minute walk than usual ambulatory oxygen for patients with chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis.

Detailed Description

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For patients with chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF), disease progression leads to hypoxic respiratory failure necessitating the use of long-term oxygen therapy (LTOT). However a number of studies have shown that despite being on LTOT at home many patients with COPD still experience episodes of intermittent hypoxia (reduction in oxygen saturation \<90%). These episodes occur during rest, sleep, talking, walking and sleep. These episodes of intermittent hypoxia can be harmful as they can lead to the development of ischaemic heart disease, induce pulmonary hypertension and affect brain function.

In order to reduce these episodes of intermittent hypoxia, the investigators have designed an auto-titrating, closed-loop oxygen system which automatically adjust the flow of oxygen to match a given oxygen saturation target. This allows individualisation and optimisation of oxygen therapy for every patient.

Mechanism of action:

A pulse oximeter is attached to the ear or finger of a patient. This send the oxygen saturation reading to a control centre (located in a mobile phone). The control centre is pre-programmed to maintain a set oxygen saturation target. The control centre outputs a signal to a flow meter which regulated the outflow of oxygen.

In this study, the investigators will recruit patients with COPD on LTOT and patients with IPF on LTOT or ambulatory oxygen to undergo three 6 minute walk tests (6MWT). The first will be on air (practice walk), the second will be on their usual ambulatory oxygen and the third on the auto-titrating oxygen system. The order of the second and third walks be randomly selected. The patient will be blinded as to which type of oxygen they will be receiving in the second and third walk.

Hypothesis: the investigators iO2t system is better at preventing and treating oxygen desaturations that occur during a 6MWT than usual fixed flow ambulatory oxygen therapy

Conditions

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Chronic Obstructive Pulmonary Disease Idiopathic Pulmonary Fibrosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Fixed flow oxygen COPD

The 6MWT will done on the patients usual fixed flow ambulatory oxygen in this arm.

Group Type NO_INTERVENTION

No interventions assigned to this group

Auto-titrating arm COPD

The 6MWT will done using the auto-titrating oxygen system in this arm of the study

Group Type EXPERIMENTAL

Auto-titrating oxygen system

Intervention Type DEVICE

The auto-titrating oxygen system contains a number of components working together to produce variable oxygen flow. An oximeter measures the oxygen saturation of a patient and via Bluetooth this is relayed to a control centre in a mobile phone. This in turn regulates a flow meter which adjust oxygen flow.

Fixed flow oxygen Pulmonary Fibrosis (IPF)

The 6MWT will done using the auto-titrating oxygen system in this arm of the study

Group Type NO_INTERVENTION

No interventions assigned to this group

Auto-titrating arm Pulmonary Fibrosis (IPF)

The 6MWT will done using the auto-titrating oxygen system in this arm of the study

Group Type EXPERIMENTAL

Auto-titrating oxygen system

Intervention Type DEVICE

The auto-titrating oxygen system contains a number of components working together to produce variable oxygen flow. An oximeter measures the oxygen saturation of a patient and via Bluetooth this is relayed to a control centre in a mobile phone. This in turn regulates a flow meter which adjust oxygen flow.

Interventions

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Auto-titrating oxygen system

The auto-titrating oxygen system contains a number of components working together to produce variable oxygen flow. An oximeter measures the oxygen saturation of a patient and via Bluetooth this is relayed to a control centre in a mobile phone. This in turn regulates a flow meter which adjust oxygen flow.

Intervention Type DEVICE

Other Intervention Names

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Intelligent oxygen therapy iO2t

Eligibility Criteria

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Inclusion Criteria

* COPD and on LTOT
* IPF on LTOT or ambulatory oxgen

Exclusion Criteria

* Unable to mobilise for a 6 minute walk test
* Unable to consent to study,
* Partial pressure of oxygen \< 6.0 kilopascals (kPa) or Partial pressure of carbon dioxide \> 8kilopascals on air,
* Exacerbation of the underlying lung disease in the previous 4 weeks
* Unstable cardiovascular disease (e.g. arrhythmia, hypertension/hypotension or angina)
* Pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anita K Simonds, MBBS MD FRCP

Role: PRINCIPAL_INVESTIGATOR

Royal Brompton & Harefield NHS Foundation Trust

Locations

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Royal Brompton and Harefield NHS Trust

London, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Moghal, M, Goburdhun, R, Hopkinson, N, Man, W, Morrell, M, Dickinson, R et al. An auto-titrating intelligent oxygen therapy (iO 2 T) system in COPD patients: A randomised cross-over trial. European Respiratory Journal. (2015). 46. OA3281. 10.1183/13993003.congress-2015.OA3281.

Reference Type RESULT

Related Links

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https://spiral.imperial.ac.uk/handle/10044/1/59707

This is completed PhD thesis of M Moghal which includes results to this study Autotitrating oxygen in Chronic Respiratory Failure

Other Identifiers

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14IC1995

Identifier Type: -

Identifier Source: org_study_id