Adjustment of Mask Pressure, for Bilevel Positive Airways Pressure Therapy, by Automated Algorithm
Adjustment of Non-invasive Positive Pressure Ventilation in Patients With Chronic Hypercapnic Ventilatory Failure Using Automated End-expiratory Pressure (AutoEEP) Algorithm
연구 개요
상태
상세 설명
Persisting ventilatory failure associated with chronic obstructive pulmonary disease (COPD), obesity-hypoventilation-syndrome, sleep apnoea or neuromuscular disease is increasingly managed with domiciliary non-invasive positive pressure ventilation (NIPPV).
Optimal settings of non-invasive ventilation are usually titrated manually and require time and expertise. The development of systems lead to automated analysis and development of algorithms to adjust ventilators. However, there is a paucity of optimal algorithms, particularly the problem of upper airway obstruction. Therefore, the central aim of this study is to develop the automated setting of an end-expiratory positive airway pressure (EPAP), because upper airway obstruction is relatively common in this group of patients. We hypothesise that an automated end-expiratory airway pressure (AutoEEP) adjusting algorithm could overcome these problems and further optimise and adjust ventilator settings. Using non-invasive ventilation in patients with hypercapnic ventilatory failure, awake and asleep, we will measure physiological outcome parameters and apply an AutoEEP algorithm, comparing it against usual care.
연구 유형
등록 (실제)
단계
- 해당 없음
연락처 및 위치
연구 장소
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Essen, 독일, 45239
- Abteilung Pneumologie - Universitätsklinik, Ruhrlandklinik
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Subjects will be patients not naive to noninvasive ventilation, and being so treated for any form of hypercapnic ventilatory failure.
- Previously stabilised on bilevel noninvasive pressure support ventilation.
- Both genders, age <75years.
- Previously shown to have a requirement for an EEP above cm H2O in order to maintain upper airway patency, or those in whom such a raised EEP would be expected, e.g. obese patients.
- Patients also known to have adequate airway patency at an EEP of 4 to 5 cm H2O will be included to ensure specificity of the algorithm.
Exclusion Criteria:
- Acute critical illness (e.g. acute coronary syndrome, stroke)
- Serious anatomical variations of nose, sinuses, pharynx or oesophagus.
- Any condition at risk of oesophageal bleeding (e.g. oesophageal varices, gastric ulcer, etc.)
- Age >75 years
- Pregnancy
- Epilepsy
- Psychiatric disorders that could possibly influence the study
- Any kind of addiction
- Insufficient knowledge of the language
- Noninvasive ventilation otherwise contraindicated
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 크로스오버 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: AutoVPAP with addition of AutoEPAP
This arm will receive conventional device modified to enable algorithm for automatically applied Expiratory Positive Airway Pressure.
Patients randomised to this group will then receive the other treatment the following night.
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Implementation of automated algorithm for adjustment of conventional device parameter (EPAP0.
Conventionally applied Expiratory Positive Airway Pressure (EPAP)
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활성 비교기: AutoVPAP without addition of AutoEPAP
This arm will receive conventionally applied Expiratory Positive Airway Pressure.
Patients randomised to this group will then receive the other treatment the following night.
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Implementation of automated algorithm for adjustment of conventional device parameter (EPAP0.
Conventionally applied Expiratory Positive Airway Pressure (EPAP)
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Index of Apneoas Plus Hypopnoeas Per Hour of Sleep (AHI)
기간: On completion of each consecutive night of polysomnography.
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The AHI is a count of the number of pauses during sleep a person experiences.
The total number of apneas/ hypopneas (sleep pauses) are divided by the total sleep time to get an index for that night
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On completion of each consecutive night of polysomnography.
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Mean SpO2
기간: On completion of each night of 2 consecutive nights polysomnography.
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During sleep, pulse oximetery is recorded through a sensor on the participants finger
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On completion of each night of 2 consecutive nights polysomnography.
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공동 작업자 및 조사자
스폰서
수사관
- 수석 연구원: Helmut Teschler, Dr. med., Abteilung Pneumologie - Universitätsklinik, Essen, Germany
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
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