Evaluation of the Efficacy and Safety of High-Flow Oxygen Therapy Compared With a Nasal Positive Airway Pressure (nPAP) Mask Using Transcutaneous Capnometry During Endoscopic Procedures in High-Risk Patients (HiPERion)
The HiPERion Trial is a prospective, randomized, controlled, non-inferiority study designed to compare the efficacy and safety of two oxygen and respiratory support methods during sedated endoscopic procedures in patients at increased risk of respiratory complications.
Patients with significant pre-existing medical conditions (American Society of Anesthesiologists [ASA] physical status III or IV) have an increased risk of breathing-related complications during endoscopic procedures performed under sedation. These complications include low blood oxygen levels (hypoxemia) and elevated carbon dioxide levels in the blood (hypercapnia).
The study will compare two respiratory support methods: high-flow nasal cannula (HFNC) oxygen therapy and a nasal positive airway pressure (nPAP) system using the SuperNO2VA mask. Both methods are used to support breathing and maintain adequate oxygen levels during medical procedures. However, they differ in their technical approach and in the way they support ventilation.
A total of 140 adult patients undergoing diagnostic or therapeutic endoscopic procedures lasting more than 15 minutes will be enrolled at the University Hospital Ulm, Germany. Eligible participants will be randomly assigned to receive either HFNC oxygen therapy or respiratory support via the nPAP mask during the procedure.
Throughout the endoscopic procedure, patients will receive standard clinical monitoring, including measurement of oxygen saturation, heart rate, and blood pressure. In addition, carbon dioxide levels will be continuously monitored using a non-invasive transcutaneous capnometry sensor attached to the patient's forehead. This method allows continuous measurement of carbon dioxide levels through the skin without the need for additional blood sampling.
The primary objective is to compare the occurrence of hypoxemic events between the two respiratory support methods. Hypoxemia is defined as a decrease in oxygen saturation below 90% lasting more than 10 seconds. Severe hypoxemic events, defined as a decrease in oxygen saturation below 80% lasting more than 10 seconds, will also be assessed.
Secondary objectives include comparing changes in transcutaneous carbon dioxide levels during the procedure, the number of interventions required to maintain an open airway or optimize respiratory support, and the occurrence of adverse events.
The study aims to determine whether respiratory support using the nPAP mask is not inferior to HFNC oxygen therapy in terms of safety and prevention of hypoxemic events during endoscopic procedures in high-risk patients. The findings may help identify an effective and safe respiratory support strategy for this patient population.
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Studientyp
Einschreibung (Geschätzt)
Phase
- Unzutreffend
Kontakte und Standorte
Studienorte
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Ulm, Deutschland, 89081
- University Hospital Ulm
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Adults aged 18 years or older.
- American Society of Anesthesiologists (ASA) physical status III or IV.
- Patients undergoing diagnostic or therapeutic endoscopic procedures with an expected duration of more than 15 minutes.
- Written informed consent to participate in the study.
Exclusion Criteria:
- Patients unable or unwilling to provide informed consent.
- Known pregnancy.
- Intolerance or contraindications to sedation.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Sonstiges
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
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Experimental: HFNC Group
High-Flow Nasal Cannula (HFNC) Oxygen Therapy |
Patients assigned to the HFNC group will receive high-flow nasal cannula oxygen therapy during the endoscopic procedure. The oxygen flow rate will be set at 40 L/min with an inspired oxygen concentration (FiO₂) of 40%. Transcutaneous carbon dioxide levels will be continuously monitored using a non-invasive forehead sensor. Standard monitoring of peripheral oxygen saturation (SpO₂), heart rate, and blood pressure will be performed throughout the procedure. |
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Aktiver Komparator: nPAP Group
Nasal Positive Airway Pressure (nPAP) Using the SuperNO2VA Mask |
Patients assigned to the nPAP group will receive respiratory support using a nasal positive airway pressure (nPAP) system with the SuperNO2VA nasal mask throughout the endoscopic procedure. Transcutaneous carbon dioxide levels will be continuously monitored using a non-invasive forehead sensor. Standard monitoring of peripheral oxygen saturation (SpO₂), heart rate, and blood pressure will be performed throughout the procedure. |
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Number of Hypoxemic Events
Zeitfenster: During the endoscopic procedure.
|
Number of hypoxemic events, defined as a peripheral oxygen saturation (SpO₂) below 90% lasting more than 10 seconds, during the endoscopic procedure. |
During the endoscopic procedure.
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Number of Severe Hypoxemic Events
Zeitfenster: During the endoscopic procedure.
|
Number of severe hypoxemic events, defined as a peripheral oxygen saturation (SpO₂) below 80% lasting more than 10 seconds, during the endoscopic procedur |
During the endoscopic procedure.
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Change in Transcutaneous Carbon Dioxide Levels (tcPCO₂)
Zeitfenster: During the endoscopic procedure.
|
Difference between the initial transcutaneous carbon dioxide level (tcPCO₂) and the mean tcPCO₂ level measured during the endoscopic procedure. Continuous non-invasive monitoring will be performed using a transcutaneous forehead sensor. |
During the endoscopic procedure.
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Number of Airway Support Interventions
Zeitfenster: During the endoscopic procedure.
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Number of airway support interventions required during the endoscopic procedure, including head repositioning and repositioning or adjustment of the nPAP mask or HFNC nasal cannula. |
During the endoscopic procedure.
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Mitarbeiter und Ermittler
Sponsor
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- 20/25 FSt/Sta Ulm
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