- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02699112
Cardiac and Respiratory Function With Non-invasive Ventilation (CARE-NIV)
Improvement of Cardiac Function and Neural Respiratory Drive Following Set up of Non-invasive Ventilation in Patients With Hypercapnic Respiratory Failure Caused by Obesity Hypoventilation Syndrome
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Respiratory failure is characterized by the incapacity of the respiratory system to maintain the normal arterial blood gas homeostasis. Specifically, the overlap of hypoxaemia and hypercapnia (PaCO2 >6 kPa) is referred to as Hypercapnic Respiratory Failure (HRF). HRF is one of the most common causes for hospital admission with high re-admission rates, therefore constitute a major burden on healthcare systems. Non Invasive Ventilation (NIV) is a well established treatment in patients with hypercapnic respiratory failure who frequently suffer with associated pulmonary hypertension (PH). NIV helps to increase arterial oxygenation and reduces hypercapnia. It is used in patients with hypercapnic respiratory failure caused by Obesity Hypoventilation Syndrome (OHS). The associated degree of PH can lead to an increased afterload of the right ventricle (RV) that causes progressive remodelling of the right heart. RV dysfunction is correlated with a reduced long term prognosis in respiratory conditions. In literature NIV is shown as effective method to treat acute hypercapnic respiratory failure in OHS.
It has not been described how NIV impacts on cardiac function and NRD in OHS.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
London, United Kingdom, SE1 7EH
- Guys and St Thomas NHS Foundation
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Confirmed diagnosis of OHS and Overlap Syndrome
- Hypercapnic respiratory failure with the need to commence NIV
- Expected to remain an inpatient for ≥ 24 hours
- Age ≥ 18 and <80 years
- BMI >30 kg/m2
- Confirmed sleep-disordered breathing
- Able to give informed consent to participation in the evaluation study
- Clinically stable without exacerbations for ≥ 6 weeks
Exclusion Criteria:
- Patients established on NIV
- Inability to tolerate NIV (< 4 hours usage at during hospital titration)
- Contraindication to NIV
- Requirement for immediate invasive mechanical ventilation at admission or any other acute critical illness
- Acute infective exacerbation
- Presence of other acute pathology or critical illness (such as pulmonary embolism)
- Presence of acute or chronic Left ventricular Cardiac Failure
- Significant Kidney or Liver disease
- Significant Anaemia
- History of Pulmonary Embolism in the previous 2 years
- Presence of cardiac congenital disease
- Presence of Primary Pulmonary Hypertension
- Presence of other severe medical problem, e.g. cancer and systemic connective tissue disease and vasculitides
- Pregnancy
- Psychological and social factors that would impair compliance with the evaluation
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patients commencing on Non Invasive Ventilation (NIV); change in Cardiac Function from baseline and at 3 months
Time Frame: 3 months
|
Patients with hypercapnic respiratory failure caused by obesity hypoventilation syndrome commencing on NIV; change in cardiac function using echocardiography at baseline and 3 months.
Measurements taken prior to NIV initiation, and follow up at 3 months.
|
3 months
|
Patients commencing on Non Invasive Ventilation (NIV); change on Nueral Respiratory Drive (NRD) from baseline and at 3 months
Time Frame: 3 months
|
Patients with hypercapnic respiratory failure caused by obesity hypoventilation syndrome commencing on NIV; change in markers of nerual respiratory drive/EMG para.
Measurements taken prior to, and after NIV initiation, and follow up at 3 months.
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patients commencing on Non Invasive Ventilation (NIV); change in Oxygenation from baseline, 6 weeks post initiation and at 3 months
Time Frame: 3 months
|
To demonstrate that the improvement in cardiac function and/or respiratory mechanics over time are associated with ongoing improvements in oxygenation by taking samples of arterial blood gases. Measurements are made prior to, during and after NIV initiation, and follow up at 3 months. |
3 months
|
Patients commencing on Non Invasive Ventilation (NIV); change in Quality of Life from baseline, 6 weeks post initiation and at 3 months
Time Frame: 3 months
|
To demonstrate the hypothesis that the improvement in cardiac function and/or respiratory mechanics over time are associated with ongoing improvements in quality of life by asking participants to complete the Medical Research Council (MRC) dyspnoea scale.
Measurement will be taken prior to NIV initiation, 6 weeks post initiation and at follow up at 3 months.
|
3 months
|
Patients commencing on Non Invasive Ventilation (NIV); change in Quality of Life from baseline, 6 weeks post initiation and at 3 months
Time Frame: 3 months
|
To demonstrate the hypothesis that the improvement in cardiac function and/or respiratory mechanics over time are associated with ongoing improvements in quality of life by asking participants to complete the modified BORG Scale (breathlessness).
Measurement will be taken prior to NIV initiation, 6 weeks post initiation and at follow up at 3 months.
|
3 months
|
Patients commencing on Non Invasive Ventilation (NIV); change in Quality of Life from baseline, 6 weeks post initiation and at 3 months
Time Frame: 3 months
|
To demonstrate the hypothesis that the improvement in cardiac function and/or respiratory mechanics over time are associated with ongoing improvements in quality of life by asking participants to complete the St George's Respiratory Questionnaire (SGRQ).
Measurement will be taken prior to NIV initiation, 6 weeks post initiation and at follow up at 3 months.
|
3 months
|
Patients commencing on Non Invasive Ventilation (NIV); change in Quality of Life from baseline, 6 weeks post initiation and at 3 months
Time Frame: 3 months
|
To demonstrate the hypothesis that the improvement in cardiac function and/or respiratory mechanics over time are associated with ongoing improvements in quality of life by asking participants to complete the Hospital Anxiety and Depression Scale (HADS). Measurement will be taken prior to NIV initiation, 6 weeks post initiation and at follow up at 3 months. |
3 months
|
Patients commencing on Non Invasive Ventilation (NIV); change in Quality of Life from baseline, 6 weeks post initiation and at 3 months
Time Frame: 3 months
|
To demonstrate the hypothesis that the improvement in cardiac function and/or respiratory mechanics over time are associated with ongoing improvements in quality of life by asking participants to complete the Epworth Sleepiness Scale (ESS). Measurement will be taken prior to NIV initiation, 6 weeks post initiation and at follow up at 3 months. |
3 months
|
Patients commencing on Non Invasive Ventilation (NIV); change in Exercise Capacity.
Time Frame: 3 months
|
To demonstrate that the improvement in cardiac function and/or respiratory mechanics over time are associated with ongoing improvements in oxygenation by participants performing the Gate speed of 4 metres test prior to,during and after NIV initiation and at 6 weeks post initiation, and follow up at 3 months.
|
3 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Joerg Dr Steier, Guys and St Thomas' NHS Foundation Trust
- Principal Investigator: Marino Dr Phil, Guys and St Thomas' NHS Foundation Trust
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
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
- 179324
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.
Clinical Trials on Hypercapnic Respiratory Failure
-
Assiut UniversityNot yet recruitingAcute Hypoxemic Respiratory Failure | Acute Hypercapnic Respiratory FailureEgypt
-
Assiut UniversityNot yet recruitingAcute Hypercapnic Respiratory Failure
-
IRCCS Azienda Ospedaliero-Universitaria di BolognaCompletedChronic Hypercapnic Respiratory FailureItaly
-
Alung TechnologiesCompletedHypercapnic Respiratory Failure, COPD, ARDSGermany
-
Institut für Pneumologie Hagen Ambrock eVResMedCompletedCOPD | Chronic Hypercapnic Respiratory FailureGermany
-
Azienda Ospedaliero Universitaria Maggiore della...CompletedAcute Hypoxic - Hypercapnic Respiratory Failure (ARF)Italy
-
Yonsei UniversityNot yet recruitingRespiratory Failure | Respiratory Insufficiency | Hypercapnic Respiratory Failure | Acute Hypoxemic Respiratory Failure | Acute Hypercapnic Respiratory Failure | Ventilatory Depression | Hypoxemic Respiratory Failure | Respiratory Depression | Hypoxemic Acute Respiratory Failure | Hypercapnic AcuteKorea, Republic of
-
IRCCS Azienda Ospedaliero-Universitaria di BolognaCompletedCOPD | Chronic Hypercapnic Respiratory FailureItaly
-
Assistance Publique - Hôpitaux de ParisDirection Générale de l'Offre de SoinsCompletedHypercapnic Respiratory FailureFrance
-
Assiut UniversityNot yet recruitingComparison Between HVNI vs Noninvasive Ventilation for Acute Hypercapnic Respiratory Failure
Clinical Trials on Parasternal EMG (EMGpara) and Transthoracic Echocardiography
-
Clinica ARS MedicaUnknown
-
Sirnak State HospitalNot yet recruitingDiabetes Mellitus, Type 1 | Diastolic Dysfunction | Systolic Dysfunction
-
University of SienaEuropean Association of Cardiovascular ImagingActive, not recruitingHeart Failure | Heart Failure With Reduced Ejection Fraction | Heart Failure With Preserved Ejection Fraction | Heart Failure With Mid Range Ejection FractionSpain, Greece, Turkey, Portugal, Australia, Belgium, Italy, Mexico, Netherlands, North Macedonia, Romania, Tunisia
-
Centre Hospitalier Universitaire, AmiensCompletedCardiac Surgery | Strains | Right Ventricle | Speckle TrackingFrance
-
University Hospital, ToulouseCompleted
-
Wonju Severance Christian HospitalNational Research Foundation of KoreaCompletedMyocardial Injury | Carbon Monoxide Poisoning | Image, BodyKorea, Republic of
-
Seoul National University HospitalNot yet recruitingLeft Ventricular Systolic Dysfunction
-
University of CalgaryActive, not recruiting
-
Kantonsspital OltenCompletedPulmonary Artery Hypertension | Chronic Hepatitis cSwitzerland