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
Studieoversikt
Status
Intervensjon / Behandling
Detaljert beskrivelse
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.
Studietype
Registrering (Faktiske)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiesteder
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Essen, Tyskland, 45239
- Abteilung Pneumologie - Universitätsklinik, Ruhrlandklinik
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
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
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Crossover-oppdrag
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: 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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Aktiv komparator: 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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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Index of Apneoas Plus Hypopnoeas Per Hour of Sleep (AHI)
Tidsramme: 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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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Mean SpO2
Tidsramme: 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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Samarbeidspartnere og etterforskere
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Helmut Teschler, Dr. med., Abteilung Pneumologie - Universitätsklinik, Essen, Germany
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 09-4225
Plan for individuelle deltakerdata (IPD)
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