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Non-invasive Mechanical Ventilation as a Rescue Therapy to Relieve Dyspnea in Patients With Stable Severe COPD

23. juni 2014 opdateret af: Yonger Ou, Guangzhou Institute of Respiratory Disease

The Efficacy of Non-invasive Mechanical Ventilation as a Rescue Therapy for Relieving Dyspnea in Patients With Stable Severe COPD

The purpose of this study is to determine whether non-invasive mechanical ventilation(NIV), playing the role as a rescue therapy , are effective in relieving exertional dyspnea in stable severe COPD patients.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Chronic obstructive pulmonary disease(COPD) is a preventable and treatable illness, which is clinically characterized by persistent airflow limitation that is usually progressive. It's well known that airflow limitation lead to air trapping particularly during exercise, resulting in increased dyspnea and limitation of exercise capacity. Thus, COPD patients often unconsciously adopt a sedentary lifestyle, probably due to distressing exertional dyspnea. The sedentarism results in physical deconditioning and alterations of the peripheral muscles, and the latter one causes more exertional dyspnea and fatigue, which in turn leads to much more sedentarism, forming the vicious cycle of sedentarism, dyspnea/fatigue and more sedentarism. Thereby, measures should be taken to interrupt this vicious cycle. Some previous studies suggested that niv acting as an add-on therapy could help unloading the inspiratory muscle, reducing the dynamic compression of the airway, diminishing the dynamic hyperinflation,to some extent, relieved dyspnea during exercise in COPD patients. However,those measures were taken during exercise, acting as an add-on therapy. Whether NIV can play a role as a rescue therapy to relieve exertional dyspnea while the patients are already undergoing optimal treatment with bronchodilator and anti-inflammatory medication is still not quite clear. Therefore, we hypothesize that niv as a rescue-therapy has the same effect on relieving dyspnea in stable severe COPD patients just like the add-on therapy.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

18

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Kina
    • Guangdong
      • Guangzhou, Guangdong, Kina, 510120
        • State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical College

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

30 år til 80 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • severe COPD (post bronchodilator FEV1/FVC < 70% and FEV1 < 50% predicted)
  • stable clinical condition(no exacerbation in the 4 weeks prior to study participation with no change in medications)
  • dyspnea as a main symptom that limited daily activities

Exclusion Criteria:

  • obvious pulmonary bullae demonstrated by chest CT scan or X-ray examination
  • facial trauma/malformation; recent facial, upper airway or upper gastrointestinal tract surgery
  • oxygen saturation(SpO2) < 88% at rest with a fraction of inspired oxygen(FiO2) ≥ 0.5
  • systolic blood pressure > 160mmHg or diastolic blood pressure > 100mmHg at rest
  • unstable angina or a myocardial infarct in the previous four weeks
  • resting sinus tachycardia ( > 120 beats/min)
  • patients with musculoskeletal or neurological disorders
  • patients who are unable to give informed consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: niv plus oxygen therapy
oxygen therapy is given during the whole experimental process, niv is given at peak exercise until the borg scale reaches it's baseline point
Enhed: niv plus oxygen therapy
NIV given on Philips Respironics BiPAP Vision apparatus.
Andre navne:
  • Philips Respironics BiPAP Vision
Aktiv komparator: oxygen therapy
oxygen therapy is given during the whole experimental process
Enhed: oxygen therapy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Borg scale
Tidsramme: baseline,repeated measurement for about ten minutes after intervention
baseline,repeated measurement for about ten minutes after intervention

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Inspiratory capacity(IC)
Tidsramme: baseline,repeated measurement for about ten minutes after intervention
baseline,repeated measurement for about ten minutes after intervention
surface electromyography(sEMG)
Tidsramme: baseline,repeated measurement for about ten minutes after intervention
baseline,repeated measurement for about ten minutes after intervention
respiratory parameters
Tidsramme: baseline,repeated measurement for about ten minutes after intervention
minute ventilation(VE); tidal volume(Vt); respiratory rate(RR); inspiratory time(Ti); total duty cycle(Ttot)
baseline,repeated measurement for about ten minutes after intervention
oxygen saturation(SpO2)
Tidsramme: baseline,repeated measurement for about ten minutes after intervention
baseline,repeated measurement for about ten minutes after intervention
Heart Rate(HR)
Tidsramme: baseline,repeated measurement for about ten minutes after intervention
baseline,repeated measurement for about ten minutes after intervention
the total recovery time
Tidsramme: repeated measurement for about ten minutes after intervention
repeated measurement for about ten minutes after intervention
mouth pressure(Pmo)
Tidsramme: baseline,repeated measurement for about ten minutes after intervention
baseline,repeated measurement for about ten minutes after intervention

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Guangzhou Institute of Respiratory Disease

Efterforskere

  • Ledende efterforsker: Rongchang Chen, M.D., Sate Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical College

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. marts 2013

Primær færdiggørelse (Faktiske)

1. april 2014

Studieafslutning (Faktiske)

1. april 2014

Datoer for studieregistrering

Først indsendt

8. december 2013

Først indsendt, der opfyldte QC-kriterier

13. december 2013

Først opslået (Skøn)

16. december 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

24. juni 2014

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. juni 2014

Sidst verificeret

1. juni 2014

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2009CB522111

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med niv plus oxygen therapy

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Betingelser

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Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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