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Patients With Pulmonary Hypertension or Interstitial Lung Disease at Altitude - Effect of Oxygen on Exercise Performance

Phase 4
Completed
Conditions
Interstitial Lung Disease
Precapillary Pulmonary Hypertension
Interventions
Behavioral: Moderate altitude sojourn
Behavioral: Low altitude sojourn
Drug: Sham oxygen (room air)
Registration Number
NCT02143687
Lead Sponsor
University of Zurich
Brief Summary

The purpose of this study is to investigate the effect of travelling to moderate altitude and of nocturnal oxygen therapy during a stay at moderate altitude on exercise performance of patients with pulmonary hypertension or with interstitial lung disease.

Detailed Description

Patients with pulmonary hypertension or with interstitial lung disease living below 800 m will be invited to participate in a randomized, cross-over field trial evaluating the hypotheses that: a), exercise capacity during a 2 day sojourn at moderate altitude is reduced in comparison to low altitude; b), exercise capacity during a 2 day sojourn at moderate altitude is improved by nocturnal oxygen therapy compared to room air (sham oxygen) administered during nights at altitude. Outcomes will be assessed at low altitude (Zurich, 490 m, baseline), and during 2 study periods of 2 days each spent at moderate altitude (St. Moritz Salastrains, 2048 m), separated by a wash-out period of at least 2 weeks spent at low altitude (\<800 m). The order of stays at the different altitudes and of the treatments will be randomized.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Precapillary pulmonary hypertension, or interstitial lung disease.
  • New York Heart Association class 2-3.
  • Residence at low altitude (<800m).
Exclusion Criteria
  • Unstable or exacerbated condition
  • Very severe pulmonary hypertension or interstitial lung disease, New York Heart Association class 4
  • Requirement for oxygen therapy at low altitude residence
  • Hypoventilation
  • More than mild or unstable cardiovascular disease
  • Use of drugs that affect respiratory center drive
  • Internal, neurologic or psychiatric disease that interfere with protocol compliance including current heavy smoking (>20 cigarettes per day), inability to perform 6 min walk test.
  • Previous intolerance to moderate altitude (<2600m).
  • Exposure to altitudes >1500m for >2 days within the last 4 weeks before the study.
  • Pregnant or nursing patients

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Moderate altitude sojournModerate altitude sojournSojourn at moderate altitude (2048 m)
Moderate altitude sojournSham oxygen (room air)Sojourn at moderate altitude (2048 m)
OxygenModerate altitude sojournOxygen administration via a nasal cannula at a rate of 3 L/min during nights spent at 2048 m
OxygenSham oxygen (room air)Oxygen administration via a nasal cannula at a rate of 3 L/min during nights spent at 2048 m
Low altitude sojournSham oxygen (room air)Sojourn at low altitude (490 m, baseline)
OxygenOxygenOxygen administration via a nasal cannula at a rate of 3 L/min during nights spent at 2048 m
Low altitude sojournModerate altitude sojournSojourn at low altitude (490 m, baseline)
Sham oxygen (room air)Moderate altitude sojournSham oxygen (room air) administration via a nasal cannula at a rate of 3 L/min during nights
Moderate altitude sojournLow altitude sojournSojourn at moderate altitude (2048 m)
Low altitude sojournLow altitude sojournSojourn at low altitude (490 m, baseline)
OxygenLow altitude sojournOxygen administration via a nasal cannula at a rate of 3 L/min during nights spent at 2048 m
Sham oxygen (room air)Low altitude sojournSham oxygen (room air) administration via a nasal cannula at a rate of 3 L/min during nights
Sham oxygen (room air)Sham oxygen (room air)Sham oxygen (room air) administration via a nasal cannula at a rate of 3 L/min during nights
Moderate altitude sojournOxygenSojourn at moderate altitude (2048 m)
Low altitude sojournOxygenSojourn at low altitude (490 m, baseline)
Sham oxygen (room air)OxygenSham oxygen (room air) administration via a nasal cannula at a rate of 3 L/min during nights
Primary Outcome Measures
NameTimeMethod
6 min walk distanceDay 2 at 2048 m

Difference in the distance walked in 6 min between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2028 m.

Secondary Outcome Measures
NameTimeMethod
6 min walk distanceday 3 at 2048 m

Difference in the distance walked in 6 min between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2028 m.

SpirometryDay 2 at 2048 m

Difference in spirometry between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2028 m.

Arterial blood gas analysisDay 2 at 2048 m

Change in arterial oxygen partial pressure, carbon dioxide partial pressure, and pH between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2028 m.

Perceived exertionDay 3 at 2048 m

Difference in the perceived exertion rated with the BORG CR10 scale at the end of the 6 min walk between measurements at 2048 m (altitude) and 490 m (baseline); and between the oxygen and sham oxygen treatment periods at 2028 m.

Severe hypoxemiaDay 1 to 3 at 2048 m

Number of participants in whom arterial oxygen saturation measured by pulse oximetry is less than 75% for more than 30 min during the sojourn at 2048 m (altitude) and 490 m (baseline); and during the oxygen and sham oxygen treatment periods at 2028 m.

Trial Locations

Locations (1)

University Hospital Zurich, Pulmonary Division

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Zurich, Switzerland

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