Hyperbaric Versus Normobaric Oxygen Therapy for COVID-19 Patients

NCT ID: NCT04500626

Last Updated: 2021-11-01

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

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

234 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-15

Study Completion Date

2022-08-31

Brief Summary

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At least 1 in 6 COVID-19 patients admitted to hospital to receive extra oxygen will die of complications. In patients with COVID-19, invasive treatment such as mechanical ventilation (e.g. breathing with a machine) is associated with a 50% increased risk of death. Invasive treatments use a lot of healthcare resources in intensive care units and may lead to further deaths if patients do not have access to care.

The investigators aim to improve outcomes for COVID-19 patients by implementing hyperbaric oxygen therapy (HBOT). HBOT allows patients to breathe 100% oxygen in a special chamber at a pressure higher than sea level. It is approved by Health Canada for 14 conditions. HBOT is safe when administered by experienced teams.

There are two main causes of death in severe COVID-19 respiratory infections: (i) a decreased diffusion of oxygen from the lungs to the blood and (ii) an increased inflammatory response (also called a "cytokine storm"). HBOT leads to increased oxygen level in blood, has strong anti-inflammatory effects, and may destroy the virus responsible for COVID-19 disease. The initial experience with HBOT and COVID-19 from China, France and the United States is promising in that it prevents further worsening of the condition and need for intensive care.

The investigators propose to test the effectiveness of HBOT for COVID-19 patients who are admitted to hospital to receive extra oxygen. Using the most rigorous and innovative research methods, this Canadian-led international study will operate at 5 centers across 3 countries (Canada: Ottawa, Toronto, Edmonton; Switzerland: Geneva; UK: Rugby/London). The investigators anticipate that when treated by HBOT, COVID-19 patients needing extra oxygen to breathe will see significant health improvements as well as a decrease in complications, inflammation in the blood, need for invasive care, death, and cost of care.

Detailed Description

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Conditions

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Covid19

Keywords

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Hyperbaric oxygen therapy

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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HBOT

These patients will receive hyperbaric oxygen therapy (HBOT) in addition to usual treatment for COVID-19. HBOT sessions will be 75 minutes in length at a pressure of 2.0 ATA.

Group Type EXPERIMENTAL

Oxygen

Intervention Type DRUG

Hyperbaric oxygen therapy delivered in a monoplace or multi-place chamber. Supervised by a hyperbaric oxygen therapy physician and a chamber operator.

Control

These patients will receive usual treatment for COVID-19, including oxygenation at normal atmospheric pressure (normobaric oxygenation).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Oxygen

Hyperbaric oxygen therapy delivered in a monoplace or multi-place chamber. Supervised by a hyperbaric oxygen therapy physician and a chamber operator.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Male or non-pregnant female patients
* Age ≥18 years
* Confirmed COVID-19 positive by RT-PCR or another validated method
* Diagnosed with pneumonia requiring 21%\<FIO2≤100% to maintain saturation by pulse oximetry (SpO2) ≥90%
* Able and willing to comply with study procedures and follow-up examinations contained within the written consent form

Exclusion Criteria

* Patient clinical status felt to be incompatible with HBOT, e.g. respiratory failure requiring mechanical ventilation
* Pregnancy, determined by a serum or urine test
* Hemodynamic instability requiring vasopressors
* Inability to maintain a sitting position during treatment
* Inability to effectively understand and communicate with the hyperbaric operator, or to give consent
* Inability to spontaneously equalize ears and refusal of myringotomies
* Contraindications to HBOT (e.g. pneumothorax)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Climate Foundation

UNKNOWN

Sponsor Role collaborator

Ottawa Hospital Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sylvain Boet, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

The Ottawa Hospital

Locations

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The Ottawa Hospital

Ottawa, Ontario, Canada

Site Status NOT_YET_RECRUITING

Rouge Valley Hyperbaric Medical Centre

Scarborough Village, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Sylvain Boet, MD, PhD

Role: CONTACT

Phone: 613-737-8899

Email: [email protected]

Joseph Burns, MSc

Role: CONTACT

Phone: 613-798-5555

Email: [email protected]

Facility Contacts

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Sylvain Boet, MD, PhD

Role: primary

Joseph Burns, MSc

Role: backup

Rita Katznelson, MD

Role: primary

Research Coordinator

Role: backup

Related Links

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https://www.medrxiv.org/content/10.1101/2020.07.15.20154609v1

Preprint of study protocol (brief version for publication)

Other Identifiers

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OHRI-HBOT-001

Identifier Type: -

Identifier Source: org_study_id