Regional Ventilation During High Flow Nasal Cannula and Conventional Nasal Cannula in Patients With Hypoxia
NCT ID: NCT02943863
Last Updated: 2016-10-25
Study Results
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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COMPLETED
NA
24 participants
INTERVENTIONAL
2014-09-30
2015-02-28
Brief Summary
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The mechanisms of the effects of HFNC are thought to be related to the favorable effects of the heated and humidified gas, the high-flow rate used to minimize the entrainment of room air, and an increase in the ventilation efficiency, including the elimination of nasopharyngeal dead space, positive end-expiratory pressure (PEEP) effects, and improvements in paradoxical abdominal movement. Regarding the effects on lung volume, global ventilation in the lungs increases during HFNC, which is thought to attribute to PEEP effects. However, how regional ventilation is affected during HFNC in comparison with conventional NC remains unknown.
Because PEEP in mechanically ventilated patients improves the regional homogeneity of ventilation, investigators postulated that HFNC via PEEP effects would result in more homogeneous regional distributions in the ventilation changes. Investigators therefore assessed global and regional ventilation in patients with hypoxia receiving care via HFNC using electric impedance tomography and compared these results with conventional nasal cannula.
Detailed Description
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Conditions
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Study Design
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RANDOMIZED
CROSSOVER
TREATMENT
NONE
Study Groups
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HFNC first
Patients in "HFNC first" receive oxygen therapy using HFNC in ahead of conventional nasal cannula oxygen therapy. After 20 minutes of HFNC therapy, patients receive conventional nasal cannula oxygen therapy.
HFNC followed by conventional nasal cannula
LFS first
Patients in "LFS first" receive oxygen therapy using conventional nasal cannula in ahead of HFNC therapy. After 20 minutes of conventional nasal cannula oxygen therapy, patients receive HFNC oxygen therapy.
Conventional nasal cannula followed by HFNC
Interventions
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HFNC followed by conventional nasal cannula
Conventional nasal cannula followed by HFNC
Eligibility Criteria
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Inclusion Criteria
* Subjective dyspnea in room air
* SaO2\< 90% in room air
* Oxygen requirement for nasal cannula \< 6 L/m
Exclusion Criteria
* SBP \<90 mmHg
* DBP \< 60 mmHg
* Heart rate \> 120 bpm
* Respiratory rate \> 30 bpm
* Persistent dyspnea under oxygen therapy using NC
* Severe hypoxia
* PaO2/FiO2\< 200 mmHg
* Unable to cooperate
* Delirium
* Reduced cognitive function
20 Years
ALL
No
Sponsors
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Ministry of Trade, Industry & Energy, Republic of Korea
OTHER_GOV
Asan Medical Center
OTHER
Responsible Party
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Chae-Man Lim
Professor of Pulmonary and Critical Care Medicine, College of Medicine, University of Ulsan. Chief Director of Intensive Care Units, Asan Medical Center
Principal Investigators
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Chae-Man Lim, MD
Role: PRINCIPAL_INVESTIGATOR
Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan
References
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Spoletini G, Alotaibi M, Blasi F, Hill NS. Heated Humidified High-Flow Nasal Oxygen in Adults: Mechanisms of Action and Clinical Implications. Chest. 2015 Jul;148(1):253-261. doi: 10.1378/chest.14-2871.
Riera J, Perez P, Cortes J, Roca O, Masclans JR, Rello J. Effect of high-flow nasal cannula and body position on end-expiratory lung volume: a cohort study using electrical impedance tomography. Respir Care. 2013 Apr;58(4):589-96. doi: 10.4187/respcare.02086.
Hsu CF, Cheng JS, Lin WC, Ko YF, Cheng KS, Lin SH, Chen CW. Electrical impedance tomography monitoring in acute respiratory distress syndrome patients with mechanical ventilation during prolonged positive end-expiratory pressure adjustments. J Formos Med Assoc. 2016 Mar;115(3):195-202. doi: 10.1016/j.jfma.2015.03.001. Epub 2015 Apr 3.
Lee DH, Kim EY, Seo GJ, Suh HJ, Huh JW, Hong SB, Koh Y, Lim CM. Global and Regional Ventilation during High Flow Nasal Cannula in Patients with Hypoxia. Acute Crit Care. 2018 Feb;33(1):7-15. doi: 10.4266/acc.2017.00507. Epub 2018 Jan 22.
Other Identifiers
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OMNI
Identifier Type: -
Identifier Source: org_study_id