Heliox over het ademhalingswerk bij volwassen patiënten met stenose van de lagere luchtwegen
Het effect van Heliox op de ademhaling bij volwassen patiënten met stenose van de lagere luchtwegen
Heliox (a mixture of Helium and Oxygen) can reduce the work of breathing in patients with airway stenosis by modifying turbulent flow into laminar flow. The aim of this study was to analyze the effect of Heliox versus conventional oxygen therapy in patients with lower airway stenosis on muscular effort measured by electromyography and diaphragmatic ultrasound, thoracoabdominal synchrony assessed with plethysmographic bands, dyspnea, stridor, oxygen saturation, transcutaneous carbon dioxide value, blood pressure, heart rate and respiratory rate.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
Lower airway stenosis results in increased work of breathing with stridor and dyspnea, as a consequence of the increased resistances caused by the reduction in airway diameter. Airway resistance also depends on the length of the airway and the type of gas flow. Heliox (a mixture of Helium and Oxygen) is a gas less dense than air, which can change the flow from turbulent to laminar, reducing airway resistance by 20 to 40%, and therefore decreasing the work of breathing. Heliox is an inert gas that does not react with biological membranes, so there are few complications associated with its use, the most relevant being hypoxemia when fixed mixtures are not used and the the fraction of inspired oxygen (FiO2) supplied is less than 21%. The aim of the study was to evaluate if during the perioperative period of lower airway stenosis the administration of Heliox compared to oxygen could reduce the work of breathing and improve dyspnea. For this purpose, patients were treated for 30 minutes with Heliox (fixed mixture of 70% helium and 30% oxygen) using a non rebreather mask or reservoir bag versus 30 minutes with oxygen 31% using a Venturi mask.
Studietype
Studietype
Inschrijving (Werkelijk)
Inschrijving
Contacten en locaties
Studie Locaties
-
-
Madrid
-
Madrid, Madrid, Spanje, 28041
- Marta Corral Blanco
-
-
Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Patients will be recluted from the pneumology outpatient clinic of the Hospital 12 de Octubre
Beschrijving
Inclusion Criteria:
- Patients with lower airway stenosis evaluated at the Respiratory Endoscopy Unit of the Hospital Universitario 12 de Octubre on the waiting list for endoscopic intervention on stenosis.
- Stenosis grade ≥ 3 and Borg scale score > 2.
Exclusion Criteria:
- Presence of relevant comorbidities (uncontrolled ischemic heart disease, ventricular dysfunction, pneumopathies with severe respiratory insufficiency, severe pulmonary hypertension).
- Inability to perform the test due to severe dyspnea or need for emergency intervention.
- Patient on continuous mechanical ventilation, invasive or non-invasive.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Observatiemodellen: COHORT
- Tijdsperspectieven: PROSPECTIVE
Aantal groepen / cohorten
Cohorten en interventies
Groep / CohortGroep / Cohort |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Airway Stenosis
Patients with lower airway stenosis on waiting list for endoscopic intervention on stenosis by respiratory endoscopy unit. |
Treatment for 30 minutes with Heliox from a commercial tank (Oxhelⓒ, Air Liquideⓒ) with a fixed mixture of 70% helium and 30% oxygen with non-rebreather mask or reservoir bag at a flow of 12-15 lpm.
Andere namen:
Treatment for 30 minutes with oxygen at FiO2 of 31% with Venturi mask.
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Changes in Neural Ventilatory Drive (%):
Tijdsspanne: 30 minutes with Heliox and 30 minutes with Oxygen 31%
|
Percentage over the Root Mean Square peak for parasternal electromyography (EMG): averaged of the square root of the peak value and the area under the curve of parasternal EMG (%RootMeanSquare) adjusted for respiratory frequency, as a surrogate of diaphragmatic EMG, and sternocleidomastoid EMG, which will give us information on accessory muscle activation. |
30 minutes with Heliox and 30 minutes with Oxygen 31%
|
Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Diaphragmatic excursion assessed with ultrasound
Tijdsspanne: At minute 15 during the Heliox test and at minute 15 during the Oxygen 31% test.
|
Assessment of muscular effort by measuring the diaphragmatic excursion (mm) at tidal volume and at vital capacity. |
At minute 15 during the Heliox test and at minute 15 during the Oxygen 31% test.
|
|
Thickening fraction of the diaphragm assessed by ultrasound
Tijdsspanne: At minute 15 during the Heliox test and at minute 15 during the Oxygen 31% test.
|
Assessment of muscular effort by measuring the thickening fraction of the diaphragm in the apposition zone (%). |
At minute 15 during the Heliox test and at minute 15 during the Oxygen 31% test.
|
|
Changes in thoracoabdominal synchrony
Tijdsspanne: Phase angle was calculated from 10 consecutive breaths at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
Assessment of thoracoabdominal synchrony using thoracic and abdominal belts by calculating the phase angle with the Lissajoux loop method (plotting abdominal motion on the x-axis against thoracic motion on the y-axis). |
Phase angle was calculated from 10 consecutive breaths at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
|
Borg Scale Dyspnea evolution (points)
Tijdsspanne: Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
Degree of dyspnea will be determined by this validated scale with a result between 1 and 10 points.0: Not at all 0.5: Very, very light (hardly noticeable) 1: Very light, 2: Light, 3: Moderate , 4: Somewhat intense, 5: Intense, 6: Between 5 and 7, 7: Very intense, 8: Between 7 and 9, 9: Very, very intense (almost maximum ), 10: Maximum |
Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
|
Oxygen saturation
Tijdsspanne: Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
Measured by pulse-oximetry |
Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
|
Transcutaneous partial pressure of carbon dioxide
Tijdsspanne: Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
Transcutaneous monitor uses a noninvasive technique to measure the skin-surface partial pressure of carbon dioxide (PtcCO2) |
Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
|
Blood pressure
Tijdsspanne: Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
Non-invasive measurement with a sphygmomanometer |
Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
|
Heart rate
Tijdsspanne: Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
number of beats per minute |
Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
|
Respiratory rate
Tijdsspanne: Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
Number of breaths per minute |
Basal value and at minutes 1, 5, 15 and 30 during the Heliox test and the Oxygen 31% test.
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Marta Corral Blanco, MD, Hospital 12 de Octubre
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Werkelijk)
Primaire voltooiing
Studie voltooiing (Werkelijk)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
Andere studie-ID-nummers
- HELIOX ON AIRWAY STENOSIS
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .