Efficacy and Physiology of Nasal High Flow Therapy
- Conditions
- Pulmonary Disease, Chronic Obstructive
- Interventions
- Device: NHF therapyOther: Long term Oxygen Therapy (LOT)
- Registration Number
- NCT02083120
- Lead Sponsor
- Institut für Pneumologie Hagen Ambrock eV
- Brief Summary
The effects of a nasal high-flow (NHF) therapy in patients with chronic obstructive hypercapnic respiratory failure are still not sufficiently known yet.
The aim of this study is a step-by-step generation of physiological data about gas exchange and respiration under high flow therapy using a nasal cannula with an AIRVO 2 device to provide NHF, leading to an analysis of the effects of high flow on PCO2 levels, exercise capacity, quality of life and gas exchange in a long term home treatment compared to a standard low flow long term oxygen therapy (LOT).
Hypothesis: NHF and LOT therapy show differences in measured mean overnight transcutaneous carbon dioxide partial pressure (PCO2) after four weeks of treatment.
- Detailed Description
Stage 1: Respiratory Physiology. Aim of this Stage is to investigate the effects of nasal High Flow (NHF) therapy in patients in progressed stages of COPD, by measuring physiologic parameters like tidal volume, breathing frequency and expiratory PCO2 concentration.
Stage 2: Efficacy of short term NHF. Aim of this Stage is to evaluate the efficacy of two flow rates (20 L/min and 35 L/min) regarding alveolar ventilation in overnight therapy. For this reason, patients will have two PSG sleep studies during their hospital stay, under 20 L/min and 35 L/min NHF therapy in randomized order.
Stage 3: Home Care monitoring. Aim of this Stage is to compare long term influences of NHF and LOT on PCO2 levels randomised crossover, 4 weeks each treatment.
Stage 4: Long Term Home Care monitoring . Aim of this stage is the long term follow up (12 month) of patients to examine the compliance of a sufficient NHF therapy. Patients will retain the NHF therapy if they are responders (PCO2 improvement in stage 3 of at least 2 mmHG with NHF versus LOT) and willing and able to use NHF and a patient log.
All patients will be monitored for the next 12 month. After 6 month there will be a control phone call.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 46
- Age 40-80
- Male and female
- COPD patients with chronic respiratory insufficiency (pH >7.35 and PCO2 > 50mmHg)
- Stable respiratory situation
- Decompensated heart, liver or kidney failure.
- Pregnancy or nursing period
- Participation in another clinical trial within the last 4 weeks
- Drug abuse
- Incapable of giving consent
- Known obstructive sleep apnea syndrome (OSA) (AHI>10)
- noninvasive ventilation (NIV) therapy
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description nasal High Flow and Oxygen NHF therapy overnight nasal High Flow (NHF) therapy+ individually titrated supplemental oxygen (2-6 L/min),total 35 L/min, 4 weeks at home Long term Oxygen Therapy (LOT) Long term Oxygen Therapy (LOT) individually titrated supplemental oxygen (2-6 L/min), 4 weeks at home nasal High Flow and Oxygen Long term Oxygen Therapy (LOT) overnight nasal High Flow (NHF) therapy+ individually titrated supplemental oxygen (2-6 L/min),total 35 L/min, 4 weeks at home
- Primary Outcome Measures
Name Time Method mean overnight transcutaneous PCO2 after 12 month All patients will be monitored under NHF or another sufficient therapy for the next 12 month followed by another mean overnight transcutaneous PCO2 level measure.
- Secondary Outcome Measures
Name Time Method quality of life with Saint Georges Respiratory Questionnaire (SGRQ) after 4 weeks, 8 weeks and 12 month SGRQ is a disease-specific instrument designed to measure impact on overall health, daily life, and perceived well-being in patients with obstructive airways disease.
Trial Locations
- Locations (1)
Helios Klinik Ambrock
🇩🇪Hagen, NRW, Germany