Impact of High-level Oxygen Therapy on the Reconditioning of Type I Hypoxemic Respiratory Insufficiency Patients in Intensive Care
High-throughput oxygen therapy is known as an alternative to non-invasive ventilation, with a benefit in terms of survival in non-hypercapnic respiratory failure patients.
The use of high-throughput oxygen therapy is well studied in stable chronic obstructive pulmonary disease (COPD) patients and has as known effects the decrease of transcutaneous CO2 and respiratory rate, and the increase in the inspiratory/expiratory time report, in the tidal volume and in the forced expiratory volume per second.
In the event of an exacerbation, high-flow oxygen therapy has shown to be beneficial in terms of increased mean airway pressure, tidal volume with a decrease in hypercapnia, and respiratory rate.
The net effect on the CO2 pressure is linked to the CO2 clearance of the dead anatomical space by the high throughput. The effect can be compared with the one of non invasive ventilation in a stable COPD patient.
Oxygen therapy, even in patients with non-hypoxic COPD at rest, has benefits in terms of performance and improvement of quality of life. High-throughput oxygen therapy has also shown a benefit in COPD patients in revalidation units, in terms of exercise performance and oxygenation.
However, the reconditioning of critical patients in acute situations, by means of nasal goggles, has never been studied.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Brussels, Belgium, 1020
- CHU Brugmann
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Acute respiratory insufficiency type I, oxygen partial pressure (PaO2) <60 mmHg under oxygen without hypercapnia.
- Invasive arterial pressure measure
Exclusion Criteria:
- Hemodynamic instability
- Patient under continuous high throughput oxygen therapy
- Left cardiac insufficiency
- Arteritis of the lower limbs
- Neuromuscular pathology
- Osteo-articular limitations
- Hemoglobin inferior to 8g/dl
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Optiflow nasal googles
Oxygen provided by means of high throughput nasal googles (Optiflow, Fisher&Paykel- New Zealand).
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The measurements are carried out on a max effort of 12 minutes on a cyclometer ergometer with a constant load (Motomed viva2 light).
A first effort is made with a Venturi type mask whose Inspired Fraction in Oxygen (FiO2) is set for a pulsated oxygen saturation (SpO2) greater than or equal to 85%, and then a second at 2h interval with high-throughput googles (Optiflow) with the corresponding FiO2.
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Active Comparator: Venturi mask
Oxygen provided by means of a Venturi mask.
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The measurements are carried out on a max effort of 12 minutes on a cyclometer ergometer with a constant load (Motomed viva2 light).
A first effort is made with a Venturi type mask whose Inspired Fraction in Oxygen (FiO2) is set for a pulsated oxygen saturation (SpO2) greater than or equal to 85%, and then a second at 2h interval with high-throughput googles (Optiflow) with the corresponding FiO2.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Pulsated oxygen saturation (Sp02)
Time Frame: Baseline
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SpO2 is an estimate of the amount of oxygen in the blood.
More precisely, it represents the percentage of oxygenated hemoglobin (containing oxygen) relative to the total amount of hemoglobin in the blood (oxygenated hemoglobin and non-oxygenated hemoglobin).
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Baseline
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Pulsated oxygen saturation (Sp02)
Time Frame: 12 minutes (maximal effort)
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SpO2 is an estimate of the amount of oxygen in the blood.
More precisely, it represents the percentage of oxygenated hemoglobin (containing oxygen) relative to the total amount of hemoglobin in the blood (oxygenated hemoglobin and non-oxygenated hemoglobin).
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12 minutes (maximal effort)
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Oxygen inspired fraction (FiO2)
Time Frame: Baseline
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Oxygen inspired fraction (FiO2) is the fraction or percentage of oxygen present in the gas mixture that a person breathes.
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Baseline
|
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Oxygen inspired fraction (FiO2)
Time Frame: 12 minutes (maximal effort)
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Oxygen inspired fraction (FiO2) is the fraction or percentage of oxygen present in the gas mixture that a person breathes.
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12 minutes (maximal effort)
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Blood gasometry
Time Frame: Baseline
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Arterial blood analysis
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Baseline
|
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Blood gasometry
Time Frame: 12 minutes (maximal effort)
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Arterial blood analysis
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12 minutes (maximal effort)
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Heart rate
Time Frame: Baseline
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The heart rate is the number of heartbeats per unit minute.
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Baseline
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Heart rate
Time Frame: 12 minutes (maximal effort)
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The heart rate is the number of heartbeats per minute.
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12 minutes (maximal effort)
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Respiratory rate
Time Frame: Baseline
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Number of breath cycles (inspiration and expiration) per minute.
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Baseline
|
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Respiratory rate
Time Frame: 12 minutes (maximal effort)
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Number of breath cycles (inspiration and expiration) per minute.
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12 minutes (maximal effort)
|
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Mean arterial pressure
Time Frame: Baseline
|
Mean arterial pressure
|
Baseline
|
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Mean arterial pressure
Time Frame: 12 minutes (maximal effort)
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Mean arterial pressure
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12 minutes (maximal effort)
|
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Systolic blood pressure
Time Frame: Baseline
|
Systolic blood pressure (pressure in the artery as the heart contracts)
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Baseline
|
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Systolic blood pressure
Time Frame: 12 minutes (maximal effort)
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Systolic blood pressure (pressure in the artery as the heart contracts)
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12 minutes (maximal effort)
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Borg score
Time Frame: 12 minutes (maximal effort)
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The Borg scale is a quantitative measure of the perception of effort during exercise.
The scale between 0 and 10 was designed to approximate the heart rate of a healthy young adult (effort 8 represents 80% of the cardiac frequency).
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12 minutes (maximal effort)
|
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Forced expiratory volume per second (FEV1)
Time Frame: Baseline
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The "Forced Expiratory Volume Per Second" (FEV1) is the volume of air exhaled during the first second of a so-called "forced" exhalation, following deep inspiration.
It is measured by spirometry.
|
Baseline
|
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Functional residual capacity (CFR)
Time Frame: Baseline
|
Volume of air remaining in the airways after a spontaneous expiration (not forced)
|
Baseline
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Age
Time Frame: Baseline
|
Age
|
Baseline
|
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Sex
Time Frame: Baseline
|
Sex
|
Baseline
|
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Weight
Time Frame: Baseline
|
Weight
|
Baseline
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Sébastien Redant, CHU Brugmann
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CHUB-BPCO
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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