- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03504514
Evaluation of the Effect of a Speech Detection Tool on the Improvement of Phonation in Neuromuscular Patients Dependent on Mechanical Ventilation (Ventiphono)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Nowadays, the first line treatment of chronic respiratory failure in neuromuscular disorder is non invasive ventilation (NIV). However, while NIV can compensate the respiratory disability and significantly delays significantly the necessity for invasive ventilation with a tracheostomy (IVT), it is used for significant periods of time during daytime in patients with severe respiratory failure and can therefore interfere with patients' speech. Moreover, if NIV becomes inefficient, IVT may be required to pursue ventilatory support to treat the respiratory failure; tracheostomy also interferes with phonation and specific adaptations are necessary to optimize phonation and speech quality.
Adaptation of ventilation parameters (mainly triggering sensitivity and use of positive expiratory pressure (PEP)) can significantly improve speech quality and therefore ventilated patients' communication. These adapted parameters are not strictly necessary for ventilation outside of speaking periods. It would be of interest to be able to use them exclusively during speech. In neuromuscular patients, the major motor disability constitutes a challenge as most patients are unable to use themselves the controls of their ventilator (and to potentially switch to a speech adapted ventilation program). We want to evaluate a device able to automatically detect speech and to transitorily switch from the patient's usual ventilation parameters to speech specific parameters set to optimize phonation quality.
Specific adaptations differs between NIV or IVT, therefore we will evaluation two groups of ventilation dependent patients divided according to their ventilation mode.
We believe that this device may improve the speech of NIV patients as well as IVT patients. Patients would benefit from an appropriate ventilator support without any ventilation desynchronization during speech. Speech would be more fluent and natural which would result in improved communication.
Objectives The main objective of this study is to demonstrate that phonation is improved by the use of a device allowing the transitory switch to specific speech parameters of ventilation in neuromuscular ventilator dependent patient whether during NIV or during IMT.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Hélène PRIGENT, MD PhD
- Phone Number: 0033147107911
- Email: helene.prigent@aphp.fr
Study Contact Backup
- Name: Isabelle BOSSARD
- Phone Number: 0033147104615
- Email: isabelle.bossard@aphp.fr
Study Locations
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-
-
Garches, France, 92380
- Recruiting
- Raymond Poincaré Hospital
-
Contact:
- Hélène PRIGENT, MD PhD
- Phone Number: 0033147107911
- Email: helene.prigent@aphp.fr
-
Principal Investigator:
- Hélène PRIGENT, MD PhD
-
Contact:
- Isabelle BOSSARD
- Phone Number: 0033147104615
- Email: isabelle.bossard@aphp.fr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- adult patients (age > or equal to 18)
- Neuromuscular patients with a restrictive respiratory failure without major bulbar involvement.
- Adult patient.
- Ventilator dependancy= ventilation duration of 16h/day or more either with NIV or IMT
- Leak ventilation for IMT patients
- Respiratory autonomy of at leat 1h per day
- Usual ventilation mode : assist control mode (either pressure or volume controlled mode) ou spontaneous breathing mode with target volume
- Stable hemodynamic state
- Signed informed consent
Exclusion Criteria:
- Refusal to participate
- Use of cuffed tracheostomy tube
- Inability to read
- Pregnancy
- Protected adults
- Acute respiratory failure
- Hemodynamic instability
- not registered with the social security system
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Conventional mechanical ventilation
Conventional mechanical ventilation, with patient ventilator usual parameters
|
|
Experimental: Adapted mechanical ventilation
Mechanical ventilation with parameters specifically modified to improve speech the effect is evaluated with speech trials during different ventilation conditions
|
ventilator parameters are modified
reading duration, vocal flow, intelligibility and voice quality will be evaluated during speech
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
reading duration
Time Frame: 15 minutes
|
duration for reading a specific text in seconds
|
15 minutes
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Vocal flow
Time Frame: 15 minutes
|
vocal flow in syllables/second during the reading of a specific text
|
15 minutes
|
vocal range
Time Frame: 2 minutes
|
vocal range from lowest to highest pitch
|
2 minutes
|
intelligibility
Time Frame: 15 minutes
|
evaluation of intelligibility during reading evaluated by listeners blinded to ventilation conditions
|
15 minutes
|
Speech quality
Time Frame: 5 min
|
evaluation of prosodia by listeners blinded to ventilation conditions
|
5 min
|
Speech quality
Time Frame: 1 minute
|
evaluation of speech quality by the patient using a visual analogical scale
|
1 minute
|
Speech comfort
Time Frame: 1 minute
|
evaluation of speech comfort by the patient using a visual analogical scale
|
1 minute
|
Respiratory comfort
Time Frame: 1 minute
|
evaluation of respiratory comfort by the patient using a visual analogical scale
|
1 minute
|
dyspnea
Time Frame: 1 minute
|
evaluation of dyspnea during speech evaluated with the modified Borg scale (ranking from 0 to10)
|
1 minute
|
oxygen saturation
Time Frame: 15 min
|
evaluation of Respiratory tolerance during speech by measuring oxygen saturation
|
15 min
|
respiratory rate
Time Frame: 15 min
|
evaluation of Respiratory tolerance during speech by measuring respiratory rate
|
15 min
|
cardiac frequency
Time Frame: 15 min
|
evaluation of Cardiovascular tolerance during speech by measuring cardiac frequency
|
15 min
|
Patient satisfaction
Time Frame: 1 minute
|
evaluation of Patient satisfaction with speech with the ventilation mode by the patient using a visual analogical scale
|
1 minute
|
Collaborators and Investigators
Investigators
- Principal Investigator: Hélène Prigent, MD PhD, Raymond Poincaré Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- 2017-A00109-44
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
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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