Comparison of Regional Ventilation Pattern During High Flow Nasal Cannula Between Conventional Low Flow System Nasal Cannula in Patients With Mild to Moderate Hypoxia
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 24
- 主要终点
- Tidal variation
研究概览
简要总结
High-flow nasal cannula (HFNC) that uses heated and humidified oxygen was recently introduced for bedside care. It has been shown to be associated with reduced risks of tracheal intubation rates and mortality in adult hypoxic patients.
The mechanisms of the effects of HFNC are thought to be related to the favorable effects of the heated and humidified gas, the high-flow rate used to minimize the entrainment of room air, and an increase in the ventilation efficiency, including the elimination of nasopharyngeal dead space, positive end-expiratory pressure (PEEP) effects, and improvements in paradoxical abdominal movement. Regarding the effects on lung volume, global ventilation in the lungs increases during HFNC, which is thought to attribute to PEEP effects. However, how regional ventilation is affected during HFNC in comparison with conventional NC remains unknown.
Because PEEP in mechanically ventilated patients improves the regional homogeneity of ventilation, investigators postulated that HFNC via PEEP effects would result in more homogeneous regional distributions in the ventilation changes. Investigators therefore assessed global and regional ventilation in patients with hypoxia receiving care via HFNC using electric impedance tomography and compared these results with conventional nasal cannula.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age >20 years
- •Subjective dyspnea in room air
- •SaO2< 90% in room air
- •Oxygen requirement for nasal cannula < 6 L/m
排除标准
- •Unstable vital signs
- •SBP <90 mmHg
- •DBP < 60 mmHg
- •Heart rate > 120 bpm
- •Respiratory rate > 30 bpm
- •Persistent dyspnea under oxygen therapy using NC
- •Severe hypoxia
- •PaO2/FiO2< 200 mmHg
- •Unable to cooperate
- •Reduced cognitive function
研究组 & 干预措施
HFNC first
Patients in "HFNC first" receive oxygen therapy using HFNC in ahead of conventional nasal cannula oxygen therapy. After 20 minutes of HFNC therapy, patients receive conventional nasal cannula oxygen therapy.
干预措施: HFNC followed by conventional nasal cannula (Device)
LFS first
Patients in "LFS first" receive oxygen therapy using conventional nasal cannula in ahead of HFNC therapy. After 20 minutes of conventional nasal cannula oxygen therapy, patients receive HFNC oxygen therapy.
干预措施: Conventional nasal cannula followed by HFNC (Device)
结局指标
主要结局
Tidal variation
时间窗: Twenty minutes after each oxygen therapy. (At the end of each oxygen therapy)
Tidal variation using electric impedance tomography
次要结局
- Respiration Rate(Twenty minutes after each oxygen therapy. (At the end of each oxygen therapy))
- Subjective comfort(Twenty minutes after each oxygen therapy. (At the end of each oxygen therapy))
- Oxygen saturation(Twenty minutes after each oxygen therapy. (At the end of each oxygen therapy))
研究者
Chae-Man Lim
Professor of Pulmonary and Critical Care Medicine, College of Medicine, University of Ulsan. Chief Director of Intensive Care Units, Asan Medical Center
Asan Medical Center