High-Flow Aerosol Generation Study

NCT ID: NCT05384275

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

61 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-17

Study Completion Date

2023-01-31

Brief Summary

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The study will be measuring aerosol generated from the point of tracheal extubation after cardiac surgery in patients who then receive either high-flow nasal oxygen therapy (HFNT) or standard low-flow oxygen therapy, who have been consented to participate within another randomised controlled trial (The NOTACS Study, IRAS ID 278290). Aerosol generation will be compared at various sizes of particles \< 10 microns in size and sampled in different locations in the standardised patient care rooms in the ICU. The rate of change of aerosol generation, maximum aerosol generation and duration of aerosol production greater than background will be investigated. The aim is to compare high-flow and standard low-flow oxygen therapy to determine if there is a difference in aerosol generation between the therapies.

Detailed Description

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Conditions

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Oxygen Therapy; Heart Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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No intervention: Standard Oxygen Therapy

Standard oxygen therapy arm patients will be given 30-40% inspired O2 and flow 2-6 l/min via nasal prongs or non-rebreathing mask (not humidified and not heated) post extubation. Monitoring of saturations, respiratory rate and arterial gases will happen 15 minutes post extubation and then as per local policy thereafter. If saturations \< 93% then FiO2 will be increased as per respiratory escalation protocol. Standard oxygen therapy will be given for a minimum of 16 hours post extubation.

Group Type NO_INTERVENTION

No interventions assigned to this group

High-Flow Nasal Therapy

High-flow nasal therapy arm patients will be given AIVRO 2 high flow oxygen therapy machines post extubation, start at 30-40% inspired O2 and flow 30 l/min then up to 50 l/min over 5-10 min. Monitoring of saturations, respiratory rate and arterial gases will happen after 15 minutes post extubation and then as per local policy thereafter. If saturations \< 93% then increase FiO2 as per respiratory escalation protocol. High flow nasal therapy will be given for a minimum of 16 hours post extubation.

Group Type ACTIVE_COMPARATOR

High Flow Nasal Therapy

Intervention Type DEVICE

High Flow Nasal Oxygen (Airvo2 Device)

Interventions

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High Flow Nasal Therapy

High Flow Nasal Oxygen (Airvo2 Device)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Aged 18 years or over.
2. Undergoing elective or urgent first-time or redo cardiac surgery (CABG, valve surgery, surgery on the aorta or any combination).
3. Have one or more clinical patient-related risk factor for postoperative pulmonary complications (COPD, asthma, lower respiratory tract infection in last 4 weeks as defined by use of antibiotics, body mass index ≥35 kg/m2, current (within the last 6 weeks) heavy smokers (\> 10 pack years))(26, 27).

For the purposes of the study, the following definitions apply:

Asthma is a disease characterized by recurrent attacks of breathlessness and wheezing, and patients will have been prescribed medication by inhalers or nebulisers (either bronchodilators or steroids).

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe chronic lung diseases that cause limitations in lung airflow. The more familiar terms 'chronic bronchitis' and 'emphysema' are no longer used but are now included within the COPD diagnosis. The most common symptoms of COPD are breathlessness, or a 'need for air', excessive sputum production, and a chronic cough. Patients suitable for the NOTACS study will have been prescribed medication by inhalers or nebulisers (either bronchodilators or steroids).

Exclusion Criteria

1. Requiring home oxygen therapy.
2. Deep hypothermic circulatory arrest planned.
3. Contraindication to HFNT, e.g. nasal septal defect.
4. Requirement for home respiratory support (including: CPAP, BiPAP).
5. Requiring emergency cardiac surgery defined as surgery required within 24 hours of the decision to operate.
6. Patient's not fluent in English.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Papworth Hospital NHS Foundation Trust

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Andrew Klein

Role: PRINCIPAL_INVESTIGATOR

Royal Papworth Hospital

Locations

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Royal Papworth Hospital NHS Foundation Trust

Cambridge, Cambridgeshire, United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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P02723

Identifier Type: -

Identifier Source: org_study_id