- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00686257
Evaluation Of The Total Face Mask For Emergency Application In Acute Respiratory Failure
Study Overview
Status
Conditions
Detailed Description
Despite its demonstrated efficacy in treating selected patients with acute respiratory failure, the application of NPPV is still plagued by a substantial failure rate, ranging from below 10% to above 40%. Mask intolerance ranks as one of the most common causes of failure. This is related to ill-fitting masks, mask discomfort (despite a properly fitted mask), excessively tightened straps, excessive air leaks around the mask or through the mouth, and claustrophobia.
The most commonly used masks in the acute care setting are either oronasal masks that cover the nose and mouth, or nasal masks that cover the nose alone. Both mask types usually consist of clear plastic dome-shaped mask with a soft silicon gasket to create an air seal with the skin. While this approach is usually successful, it may lead to patient discomfort and/or an air leak secondary to the difficulty in creating an effective seal over the bridge of the nose and over mobile structures such as the mandible. The Total Face Mask ™ (Respironics, Inc., Pittsburgh, PA) uses a different approach to avoid some of these limitations. Considerably larger than a standard oronasal mask, it covers the entire face and creates an air seal using a silicon gasket around the parameter of the face. In this way, gasket pressure is more evenly distributed, and discomfort over the bridge of the nose or chin is eliminated, and air leaking reduced. In addition, because one mask size fits virtually all patients, the Total Face Mask ™ facilitates the fitting process and permits more rapid initiation of ventilatory assistance. Clinical experience to date suggests that claustrophobia is not a common problem with the Total Face Mask ™ despite its size, and that its contribution to dead space is comparable to that of most oronasal masks.
The following protocol aims to compare use of the Total Face Mask ™ to the Comfort Full oronasal mask (also by Respironics, Inc., Pittsburgh, PA)or RT040 oronasal mask (Fisher&Paykel Inc., Wellington, NZ) in the acute care setting for patients meeting standard indications for NPPV.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Massachusetts
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Boston, Massachusetts, United States, 02111
- Tufts Medical Center
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Rhode Island
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Providence, Rhode Island, United States, 02903
- Rhode Island Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age>18
- Either A or B
A. Clinical Criteria: Moderate to severe respiratory distress as evidenced by tachypnea, use of accessory muscles for breathing, or abdominal paradox.
B. Blood Gas and Physiologic Criteria: Gas exchange abnormalities including PaCO2>45 with a pH<7.35, or a PaO2/FiO2 ratio<200.
Exclusion Criteria:
- The need for immediate intubation
- Medical instability such as hypotensive shock, uncontrolled cardiac ischemia or arrythmias, unstable myocardial infarction, uncontrolled upper gastrointestinal bleeding
- Agitation or uncooperativeness, unresponsive to small doses of sedatives
- Excretions or inability to protect the airway
- Inability to fit the mask
- Facial trauma
- Upper airway obstruction
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1
Patients receiving NPPV by the 'Total Face Mask'
|
NPPV is applied by this mask, as long as NPPV is received.
Other Names:
|
Active Comparator: 2
Patients receiving NPPV by 'standard oronasal mask'
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NPPV is applied by one of these masks (Comfort full or RT040 masks used at Rhode Island Hospital and Tufts Medical Center respectively), as long as NPPV is received.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Mask Comfort (as Determined by the Visual Analog Scores 1 Being Least, 10 Being Most)
Time Frame: During the first 3 hours of recruitment
|
During the first 3 hours of recruitment
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Time Required for Mask Placement
Time Frame: at the initiation of NPPV
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at the initiation of NPPV
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Early NIV Discontinuation Rate
Time Frame: During hospitalization period (after recruitment into the study)
|
Defined as the inability of the patient to be maintained on NPPV using the assigned mask while there was still an indication for ventilatory support
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During hospitalization period (after recruitment into the study)
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Deterioration Vital Signs
Time Frame: during the first 24 hours of the study
|
during the first 24 hours of the study
|
|
Deterioration in Gas Exchange
Time Frame: during the first 24 hours of the study
|
during the first 24 hours of the study
|
|
Total Length of Time Requiring NIV
Time Frame: during hospitalization (after recruitment)
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during hospitalization (after recruitment)
|
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Length of Hospital Stay
Time Frame: during hospitalization (after recruitment)
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during hospitalization (after recruitment)
|
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In-hospital Mortality Rate
Time Frame: during hospitalization (after recruitment)
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during hospitalization (after recruitment)
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Chair: Aylin Ozsancak, MD, Research Fellow
- Principal Investigator: Nicholas S. Hill, MD, Chair of Pulmonary, Critical Care and Sleep Division
- Study Director: Samy Sidhom, MD, MPH, Clinical Fellow
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB-6060
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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