Comparison of Physiological Effects of Two Types of High-Flow Oxygen Therapy in Tracheostomized Patients

NCT ID: NCT06816745

Last Updated: 2025-02-10

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-20

Study Completion Date

2025-12-30

Brief Summary

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High-flow nasal oxygen therapy offers benefits like precise oxygen delivery, flow-related positive end-expiratory pressure generation and improved lung function. High-flow oxygen therapy can be applied via tracheostomy as high-flow tracheal oxygen. While high-flow tracheal oxygen has been used to facilitate weaning, it has diminished physiological effects due to bypassing upper airways. To enhance its effectiveness, researchers developed a modified high-flow tracheal oxygen tube with a smaller expiratory end diameter to increase airway resistance and pressure. This is a prospective randomized crossover study that aims to compare the physiological effects of standard and modified high-flow oxygen therapy in tracheostomized patients.

Detailed Description

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High-flow nasal oxygen therapy has been shown to provide several physiological benefits, including precise control of the fraction of inspired oxygen, generation of flow-related positive end-expiratory pressure, increased end-expiratory lung volume, improved oxygenation, and enhanced carbon dioxide elimination. It has been widely utilized in managing acute hypoxemic respiratory failure and preventing hypoxemia after extubation.

High-flow oxygen therapy can be applied via tracheostomy as high-flow tracheal oxygen. Previous studies have reported successful cases of using high-flow tracheal oxygen to facilitate weaning from prolonged mechanical ventilation in patients with restrictive and obstructive pulmonary disorders. However, compared to high-flow nasal oxygen, high-flow tracheal oxygen exhibits significantly diminished physiological effects due to the bypassing of the narrow nasopharynx, glottis, and upper airway, as well as a more open circuit.

To address this limitation, the investigators have developed a modified high-flow tracheal oxygen tube with a reduced expiratory end tube diameter. This modification aims to create higher expiratory resistance and airway pressure, thus simulating the physiological effects of high-flow nasal cannula. This is a prospective randomized crossover physiological trial designed to compare the effects of standard and modified high-flow oxygen therapy in tracheostomized patients. Key physiological parameters will be assessed, including airway pressure, end-expiratory lung volume, vital signs, oxygenation, and respiratory workload.

Conditions

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Critical Care Oxygen Therapy Tracheostomy

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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Modified high flow tracheal oxygen

Modified high-flow tracheal oxygen with flow rates of 40L/ min and 60L/min will be performed in tracheostomized patients.

Group Type EXPERIMENTAL

Modified high flow tracheal oxygen

Intervention Type PROCEDURE

Modified high-flow tracheal oxygen with flow rates of 40L/min and 60L/min will be performed.

Standard high flow tracheal oxygen

Standard high-flow tracheal oxygen with flow rates of 40 L/min and 60 L/min will be performed in tracheostomized patients.

Group Type EXPERIMENTAL

Standard high flow tracheal oxygen

Intervention Type PROCEDURE

Standard high-flow tracheal oxygen with flow rates of 40 L/min and 60 L/min will be performed.

Interventions

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Modified high flow tracheal oxygen

Modified high-flow tracheal oxygen with flow rates of 40L/min and 60L/min will be performed.

Intervention Type PROCEDURE

Standard high flow tracheal oxygen

Standard high-flow tracheal oxygen with flow rates of 40 L/min and 60 L/min will be performed.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

Tracheostomy with stable spontaneous breathing.

Exclusion Criteria

1. Age younger than 18 years old
2. Pregnancy
3. Hemodynamic instability (mean arterial pressure \<60 mmHg, heart rate \>140 or \<60 bpm)
4. Respiratory and oxygenation instability (respiratory rate \> 35bpm or oxygen saturation measured by pulse oximetry \<90%)
5. Neuromuscular diseases or phrenic nerve injury
6. Recent trauma or surgery to the trachea, esophagus, neck, chest, or stomach
7. Pneumothorax or placement of a chest drainage
8. Contraindication to electrical impedance tomography (EIT) (implantable defibrillator)
9. Anticipating withdrawal of life support
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jian-Xin Zhou

OTHER

Sponsor Role lead

Responsible Party

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Jian-Xin Zhou

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Jian-Xin Zhou, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Capital Medical University

Locations

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Beijing Shijitan Hospital

Beijing, Beijing Municipality, China

Site Status

Countries

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China

Central Contacts

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Jian-Xin Zhou, MD, PhD

Role: CONTACT

8610 6392 6666

Shan-Shan Xu, MD

Role: CONTACT

8618501219133

Facility Contacts

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Jian-Xin Zhou, MD, PhD

Role: primary

8610 6392 6666

Shan-Shan Xu, MD

Role: backup

8618501219133

Other Identifiers

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IIT2024-158-002

Identifier Type: -

Identifier Source: org_study_id

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