Effects on Ventilation With NHF and Asymmetrical Nasal Cannulas (NHFDuet)
Nasal High Flow (NHF) in COPD - Effects on Ventilation With Asymmetrical Nasal Cannulas (NHFDuet)
The aim of this controlled randomized crossover study is to compare the physiological effects of nasal high flow therapy (NHF) with 2 different nasal cannulas in patients with exacerbated chronic obstructive pulmonary disease (ECOPD) and chronic respiratory failure.
20 patients will be treated with NHF therapy (Airvo, Fisher&Paykel Healthcare, NZ) during wakefulness. Physiological measuremends will take place over three perdiods (visits). One period without NHF, one with NHF via standard cannula (Optiflow M) and one with asymmetrical cannula (Optiflow Duet) in randomised order.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Background: Nasal High Flow (NHF) therapy had shown to increase airway pressure, reduce dead space, and improve mucociliary clearance and gas exchange in patients suffering from chronic obstructive pulmonary disease (COPD). The long-term and short-term physiological aspects of NHF are subject of ongoing research. Different flow rates and cannula sizes have been studied and found to yield different therapeutic effects. Larger sized cannulas tend to seal the nares and produce increased positive airway pressure, while smaller cannulas increase the washout effect. Currently, a new cannula is available, with one smaller and one larger opening (Optiflow+ Duet, Fisher&Paykel Healthcare, NZ).
Procedure: Following a baseline period without high flow therapy, NHF (35L/min) will be applied via the nasal cannula (Duet or Standard in randomized order). After a wash out phase, the NHF interface will be replaced for another measurement with the respective other cannula (Standard or Duet).
Respiratory rate, tidal volume, minute ventilation, inhalation to exhalation ratio (Ti/Te), transcutaneous pCO2 and intercostal EMG will be recorded during each partial measurement.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Georg N Nilius, Prof. Dr. med
- Phone Number: 22011 +49 201 174
- Email: G.Nilius@kem-med.com
Study Contact Backup
- Name: Ulrike Domanski
- Phone Number: 22058 +49 0201 174
- Email: U.Domanski@kem-med.com
Study Locations
-
-
NRW
-
Essen, NRW, Germany, 45136
- Recruiting
- Georg N Nilius
-
Contact:
- Georg Nilius
- Phone Number: 22011 +49 201 174
- Email: G.Nilius@kem-med.com
-
Contact:
- Ulrike Domanski
- Phone Number: 22058 +49 201 174
- Email: U.Domanski@kem-med.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Inpatients with COPD GOLD 3 and 4 in stable phase after acute exacerbation
- Inpatients with COPD GOLD (2, 3 and 4)
- Informed Consent
Exclusion Criteria:
- Acute respiratory insuffiency with respiratory acidosis (pH<7.35)
- Severe acute physical disease, that do not allow the subject to participate in a clinical trial
- Language, cognitive, or other barriers that make study participation impossible
- Pregnancy or Nursing
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Nasal High Flow with Optiflow M cannula
Nasal high flow treatment 35L/min with the standard symmetric nasal cannula (Optiflow M)
|
Patients with chronic obstructive pulmonary disease and chronic respiratory failure use Nasal High Flow therapy during daytime sessions of 1.5 h.
Other Names:
|
|
Active Comparator: Nasal High Flow with Optiflow Duet Cannula
Nasal high flow treatment 35L/min with the asymmetric nasal cannula (Optiflow Duet)
|
Patients with chronic obstructive pulmonary disease and chronic respiratory failure use Nasal High Flow therapy during daytime sessions of 1.5 h.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in minute ventilation (MV) comparing arm 1 and 2
Time Frame: 1.5 hours
|
Respiratory effort measured with calibrated RIP system (Respitrace QDC; Viasys Services, Lakeland, FL), MV is calculated.
Unit is L
|
1.5 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in respiratory rate (RR) comparing arm 1 and 2
Time Frame: 1.5 hours
|
Respiratory effort measured with calibrated RIP system (Respitrace QDC; Viasys Services, Lakeland, FL), RR is calculated.
Unit is breath per minute
|
1.5 hours
|
|
Change in inhalation to exhalation ratio (Ti/Te) comparing arm 1 and 2
Time Frame: 1.5 hours
|
Respiratory effort is measured with calibrated RIP system (Respitrace QDC; Viasys Services, Lakeland, FL), (Ti/Te) is calculated.
|
1.5 hours
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change oin intercostal surface EMG (surfEMG) comparing arm 1 and 2
Time Frame: 1.5 hours
|
SurfEMG is measured with EMG system (ADInstruments, NZ), it represents the neural respiratory drive, max ampltude of EMG, unit is mV
|
1.5 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
- NHFDuet 2022
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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