- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT04965844
Closed-loop Oxygen Control for High Flow Nasal Therapy (HILOOP)
26. november 2021 opdateret af: Hospital Universitari Vall d'Hebron Research Institute
Safety and Efficacy of a Closed-loop Oxygen Control for High Flow Nasal Therapy in ICU Patients: a Randomized Cross-over Study (The HILOOP Study)
In patients with acute hypoxemic respiratory failure (AHRF), High Flow Nasal Therapy (HFNT) improves oxygenation, tolerance, and decrease work of breathing as compared to standard oxygen therapy by facemask.
Current guidelines recommend adjusting oxygen flow rates to keep the oxygen saturation measured by pulse oximetry (SpO2) in the target range and avoid hypoxemia and hyperoxemia.
The hypothesis of the study is that closed loop oxygen control increases the time spent within clinically targeted SpO2 ranges and decreases the time spent outside clinical target SpO2 ranges as compared to manual oxygen control in ICU patients treated with HFNT.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
53
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Barcelona, Spanien, 08035
- Hospital Universitari Vall d'Hebron
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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
18 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Adult (>17yo) patients admitted to the ICU treated with HFNT for at least 8h
- Requiring FiO2 ≥ 30% to keep SpO2 in the target ranges defined by the clinician
- Written informed consent signed and dated by the patient or one relative in case that the patient is unable to consent, after full explanation of the study by the investigator and prior to study participation.
Exclusion Criteria:
- Patient with indication for immediate continuous positive airway pressure (CPAP), noninvasive ventilation (NIV), or invasive mechanical ventilation
- Hemodynamic instability defined as a need of continuous infusion of epinephrine or norepinephrine > 1 mg/h
- Low quality on the SpO2 measurement using finger and ear sensor (quality index below 60% on the Massimo SpO2 sensor, which is displayed by a red or orange colour bar)
- Severe acidosis (pH ≤ 7.30)
- Pregnant woman
- Patients deemed at high risk for need of mechanical ventilation within the next 8 hours
- Chronic or acute dyshemoglobinemia: methemoglobin, carbon monoxide (CO) poisoning, sickle cell disease
- Tracheotomised patient
- Formalized ethical decision to withhold or withdraw life support
- Patient under guardianship
- Patient deprived of liberties
- Patient included in another interventional research study under consent
- Patient already enrolled in the present study in a previous episode of acute respiratory failure
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: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: Oxygen close-loop
Four hours period where the fraction of inspired oxygen delivered will be automatically titrated based on SpO2 values.
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The Automatic FiO2 option provides automated adjustment of the ventilator Oxygen setting to maintain the patient's SpO2 in a defined target range.
When using the software option, the user defines the SpO2 target range, as well as the SpO2 emergency limits, and the device adjusts the Oxygen setting to keep the patient's SpO2 in the target range.
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Aktiv komparator: Manual FiO2 adjustment
Four hours period where the fraction of inspired oxygen delivered will be manually adjusted by the healthcare personnel based on SpO2 values.
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Manual FiO2 adjustment according to SpO2 values
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Percentage of time spent in optimal SpO2 range
Tidsramme: 4 hours
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The optimal SpO2 range will be defined according to the SpO2 targets determined by the clinician.
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4 hours
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Percentage of time spent in sub-optimal SpO2 range
Tidsramme: 4 hours
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SpO2 values outside the optimal range but still within an acceptable limit (2-3 percent above and below the optimal range)
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4 hours
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Percentage of time spent out of range
Tidsramme: 4 hours
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Above or below the suboptimal limits specified at the begginning of the study
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4 hours
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Percentage of time with SpO2 signal available
Tidsramme: 4 hours
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Time with SpO2 signal available
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4 hours
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Mean SpO2/FiO2
Tidsramme: 4 hours
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Mean oxygenation value
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4 hours
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ROX index
Tidsramme: 4 hours
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Is a predictor of HFNT success/failure defined as (SpO2/FiO2)/respiratory rate
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4 hours
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Percentage of time with SpO2 below 88 and 85 percent
Tidsramme: 4 hours
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Duration of time with SpO2 <85 percent and <88 percent, respectively
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4 hours
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Number of events with SpO2 below 88 and 85 percent
Tidsramme: 4 hours
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Frequency of SpO2 decreases <85 percent and <88 percent, respectively
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4 hours
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Mean FiO2
Tidsramme: 4 hours
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Mean fraction of inspired oxygen
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4 hours
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Percentage of time with FiO2 below 40 percent and above 60%
Tidsramme: 4 hours
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Percentage of time that FiO2 is <40 percent and >60 percent, respectively
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4 hours
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Number of manual adjustments
Tidsramme: 4 hours
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Frequency of manual adjustments of FiO2
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4 hours
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Number of alarms
Tidsramme: 4 hours
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Frequency of alarms
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4 hours
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Patient comfort
Tidsramme: 4 hours
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Comfort score by visual analogic scale (from 0 to 10)
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4 hours
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Helmerhorst HJ, Roos-Blom MJ, van Westerloo DJ, de Jonge E. Association Between Arterial Hyperoxia and Outcome in Subsets of Critical Illness: A Systematic Review, Meta-Analysis, and Meta-Regression of Cohort Studies. Crit Care Med. 2015 Jul;43(7):1508-19. doi: 10.1097/CCM.0000000000000998.
- L'Her E, Dias P, Gouillou M, Riou A, Souquiere L, Paleiron N, Archambault P, Bouchard PA, Lellouche F. Automatic versus manual oxygen administration in the emergency department. Eur Respir J. 2017 Jul 20;50(1):1602552. doi: 10.1183/13993003.02552-2016. Print 2017 Jul.
- Arnal JM, Garnero A, Novotni D, Corno G, Donati SY, Demory D, Quintana G, Ducros L, Laubscher T, Durand-Gasselin J. Closed loop ventilation mode in Intensive Care Unit: a randomized controlled clinical trial comparing the numbers of manual ventilator setting changes. Minerva Anestesiol. 2018 Jan;84(1):58-67. doi: 10.23736/S0375-9393.17.11963-2. Epub 2017 Jul 5.
- Roca O, Caritg O, Santafe M, Ramos FJ, Pacheco A, Garcia-de-Acilu M, Ferrer R, Schultz MJ, Ricard JD. Closed-loop oxygen control improves oxygen therapy in acute hypoxemic respiratory failure patients under high flow nasal oxygen: a randomized cross-over study (the HILOOP study). Crit Care. 2022 Apr 14;26(1):108. doi: 10.1186/s13054-022-03970-w.
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 (Faktiske)
27. april 2021
Primær færdiggørelse (Faktiske)
10. august 2021
Studieafslutning (Faktiske)
10. august 2021
Datoer for studieregistrering
Først indsendt
4. maj 2021
Først indsendt, der opfyldte QC-kriterier
7. juli 2021
Først opslået (Faktiske)
16. juli 2021
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
9. december 2021
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
26. november 2021
Sidst verificeret
1. oktober 2021
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- PR(AG)539/2020
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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