High-flow Nasal Cannula and Exercise Tolerance in COPD
Acute Effects of High-flow Nasal Cannula and Non-invasive Ventilation on Constant-load Exercise Tolerance in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
The patients underwent an initial clinical examination, with anthropometric evaluation, blood gas analysis, pulmonary function tests and measurement of maximum respiratory pressures. The exercise protocol started in the sector of Ergometry and Cardiopulmonary Exercise Testing. After completing the maximum incremental cardiopulmonary exercise test, two additional visits were scheduled for the three constant load tests. All patients studied underwent an evaluation of cardiopulmonary exercise testing (CPET). During maximum-incremental CPET, breath by breath: oxygen consumption (V̇O2, mL/min), carbon dioxide production (V̇CO2, mL/min), respiratory exchange rate (RER), minute ventilation VE (L/min), respiratory rate (bpm), equivalent ventilation for O2 and CO2 (V̇E/V̇O2 and V̇E/V̇CO2). In addition, cardiac monitoring was performed by 12-lead electrocardiogram (ECG) throughout the procedure. On the day of the experiment, the patients underwent two cardiopulmonary exercises with constant-load at 90% of the previously determined peak, separated by an interval of at least 1 hour.
The NIV parameters were adjusted for each patient with Trilogy 100 (Philips™). Spontaneous ventilation mode was set before the protocol for all patients, and a previous period of NIV adaptation was performed to titrate the inspiratory and expiratory pressures. The adaptation period started with the minimum Inspiratory Positive Airway Pressure (IPAP) value of 15cmH2O, and, every 2 minutes, increasing the pressure every 2 cmH2O according to the patient's tolerance.16 The Expiratory Positive Airway Pressure (EPAP) was programmed to vary between 4 and 6 cmH2O. Before the start of the examination, an adaptation was performed with the selected mask and initial ventilator settings for 20 min. No additional oxygen was offered.
The high flow system used was Optiflow® (Fisher & Paykel Healthcare, Auckland, New Zealand). Before the test, flow titration was performed for the patient, which started with the administration of a minimum gas flow of 30L/min and, every 2 minutes, the flow was increased by 5L/min according to patient tolerance. The test only started after 20 minutes of adaptation.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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CE
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Fortaleza, CE, Brésil, 60.430-370
- Federal University of Ceará
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Previous COPD
- FEV1 ≤ 50%
- Optimized medication
Exclusion Criteria:
- COPD Exacerbation
- Cardiac disease
- Previous neurologic disorders
- Unable to complete all protocol
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Science basique
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur actif: Control
The cardiopulmonary exercise test was performed with patient breathing room air.
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All patients underwent two cardiopulmonary exercises with constant-load at 90% of the peak workload.
The control test was performed with no additional therapy.
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Comparateur actif: NIV
The cardiopulmonary exercise test was performed with non-invasive ventilation during the test.
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All patients underwent two cardiopulmonary exercises with constant-load at 90% of the peak workload.
The NIV was used during all exercise test.
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Comparateur actif: HFNT
The cardiopulmonary exercise test was performed with a High flow nasal therapy during the test.
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All patients underwent two cardiopulmonary exercises with constant-load at 90% of the peak workload.
The high flow nasal therapy was used during all exercise test.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Exercise dinamic hyperinflation
Délai: one week after all tests
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To determine the dinamic hyperinflation during exercise test with 3-different situations , Control, NIV and HFNT.
During all testes the dinamic hyperinflation will be measured by inspiratory capacity (at rest and at the end o exercise test) and will be demonstrated as porcentage os maximum.
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one week after all tests
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Exercise Tolerance
Délai: one week after all tests
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To determine the exercise tolerance with 3-different situations , Control, NIV and HFNT.
Time of exercise test will be measured to determine which test could be the best for COPD patients.
In additional, the workload will (treadmill inclination and speed) be check to show which intervention has the better response.
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one week after all tests
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Dyspnea
Délai: one week after all tests
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To determine the dyspnea during exercise test with 3-different situations , Control, NIV and HFNT.
After all situations, Borg scale will be performed to check the dyspnea score at the end of exercise.
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one week after all tests
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Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
- 3.009.159
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
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