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Atelectasis Formation: Role of Positive Pressure Breathing, Hyperoxia, and Hypobaria

Not Applicable
Conditions
Pulmonary Atelectasis
Interventions
Other: +Gz accelerations and positive pressure breathing
Registration Number
NCT03311347
Lead Sponsor
Direction Centrale du Service de Santé des Armées
Brief Summary

The primary aim of this project is to get further knowledge of the physiology of flight atelectasis and its prevention. We seek to: 1) assess whether low levels of positive pressure breathing can prevent atelectasis formation in humans during exposure to hyperoxia and +Gz-accelerations. 2) get further knowledge on the effects of hypobaria on regional ventilation and perfusion.

A secondary aim is to evaluate the effect of anti G-trouser inflation on ventilation and regional perfusion.

Detailed Description

The effect of positive pressure breathing on lung function is being studied, when applied during exposure to hyperoxia and +Gz-accelerations. Focus is on lung tissue compression, ventilation and regional perfusion. In addition, the influence of hypobaria on these parameters is assessed.

This study is conducted in accordance with the amended Declaration of Helsinki. The Ethics Committee Ile-de-France III (ref. 3274) and the French National Agency for Drug Safety ANSM have approved the protocol (ref. ID RCB 2015-A00485-44 and ANSM 151046B-32).

Primary aim, item 1: Experiments are conducted in a human centrifuge. The protocol mimics a routine peacetime flight in combat aircraft, and includes 1hr05 min at +1Gz followed by 10-min exposure to +1.4 to +3.5Gz . Subjects are exposed three times to this sequence, breathing at positive pressure levels of 0, 5 or 10 hPa. Two groups of sixteen healthy male non-smoking volunteers, wearing anti-G trousers, are studied and compared: group 1 breathes air, group 2 100% O2.

Primary aim, item 2: Experiments are conducted in a hypobaric chamber. Sixteen healthy male non-smoking volunteers are exposed to four conditions: 0 or 15,000 ft altitude, breathing air or 100%O2. Protocol duration is 1h15min. Positive breathing pressure can be applied depending on the results of the experiments of item 1.

Secondary aim: Experiments are conducted in a human centrifuge. Sixteen healthy male non-smoking volunteers are exposed to four conditions: uninflated or inflated anti-G trousers (175 hPa), +1 or +3.5 Gz for 3 min.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Male
Target Recruitment
80
Inclusion Criteria
  • normal lung function checked by pulmonary function tests.
  • normal ECG
  • normal clinical examination

Aim 1 exclusion criteria:

  • smoking
  • myopia
  • past medical history of heart or lung disease
  • current medical treatment for heart or lung disease
  • past medical history of back pain or spine trauma or disease
  • otitis
  • bad tolerance to +Gz accelerations (G-induced loss of consciousness, motion sickness)
  • claustrophobia in the centrifuge gondola

Aim 2 exclusion criteria:

  • smoking
  • past medical history of heart or lung disease
  • current medical treatment for heart or lung disease
  • otitis
  • bad tolerance to the altitude chamber (15,000 ft): ear pain, claustrophobia
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
100%O2 breathing+Gz accelerations and positive pressure breathingPrimary aim, item 1
Air breathing+Gz accelerations and positive pressure breathingPrimary aim, item 1
Primary Outcome Measures
NameTimeMethod
atelectasis formation (change between pre and post-protocol)pre-protocol (baseline) and 1h30 min after centrifuge stop

computerized tomography: 0-5 scale for size and localization

change in pulmonary tissue density from baseline at centrifuge stop and 1h30 min after stoppre protocol (baseline), at centrifuge stop (baseline + 1h15 min) and 1h30 min after centrifuge stop

ultrasound: number of lung comets + localization

change in pulmonary ventilation between 1 Gz, 1.6 Gz and 3.5 Gzpre-protocol (baseline), baseline + 1hr, baseline +1h10 min, baseline +1h15 min

electrical impedance tomography: deltaZ on regions of interest

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (2)

Armed Forces Biomedical Research Institute

🇫🇷

Brétigny-sur-Orge, France

Department of Radiology, Percy hospital

🇫🇷

Clamart, France

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