Ignite Creation Date:
2024-05-06 @ 7:59 PM
Last Modification Date:
2024-10-26 @ 3:17 PM
Study NCT ID:
NCT06204276
Status:
RECRUITING
Last Update Posted:
2024-01-25
First Post:
2024-01-03
Brief Title:
Asymmetrical Versus Conventional High-flow Nasal Cannula in Acute Respiratory Failure
Sponsor:
Siriraj Hospital
Organization:
Siriraj Hospital
Study Overview
Official Title:
The Physiologic Effects of Asymmetrical Versus Conventional High-flow Nasal Cannula in Acute Respiratory Failure A Randomized Crossover Study
Status:
RECRUITING
Status Verified Date:
2024-01
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The goal of this randomized crossover physiological study is to evaluate the physiologic effects of asymmetrical nasal cannula and conventional nasal cannula in patients with acute respiratory failure The main questions it aims to answer are
Does the asymmetrical high-flow nasal cannula reduce the diaphragm and parasternal intercostal work activity of breathing measured by ultrasound compared to conventional high-flow nasal cannula
What is the effect of the asymmetrical high-flow nasal cannula on breathing pattern gas exchange and hemodynamic variables compared to conventional high-flow nasal cannula Participants will received asymmetrical high-flow nasal cannula or conventional high-flow nasal cannula at a flow rate of 40 and 60 Lmin in a random order
Does the asymmetrical high-flow nasal cannula reduce the diaphragm and parasternal intercostal work activity of breathing measured by ultrasound compared to conventional high-flow nasal cannula
What is the effect of the asymmetrical high-flow nasal cannula on breathing pattern gas exchange and hemodynamic variables compared to conventional high-flow nasal cannula Participants will received asymmetrical high-flow nasal cannula or conventional high-flow nasal cannula at a flow rate of 40 and 60 Lmin in a random order
Detailed Description:
High-flow nasal cannula HFNC is increasingly used in patients with acute respiratory failure The physiologic benefits of HFNC can be explained via several mechanisms These mechanisms lead to improve alveolar ventilation and decrease patients inspiratory effort directly or indirectly
Recent clinical practice guidelines recommended to use HFNC in patients with acute hypoxemic respiratory failure over conventional oxygen therapy COT and noninvasive ventilation NIV A landmark clinical study demonstrated that patients with acute hypoxemic respiratory failure who received HFNC had better survival than COT and NIV A systematic review and meta-analysis also demonstrated that HFNC significantly reduced escalation of respiratory support in patients with acute hypoxemic respiratory failure
HFNC can also be an alternative respiratory support in patients with acute on chronic hypercapnic chronic obstructive pulmonary disease COPD Several physiological and clinical studies in COPD patients with exacerbations have also suggested that HFNC was not inferior to noninvasive ventilation NIV in COPD patients with mild to moderate exacerbation in terms of gas exchange treatment failure intubation rate and mortality rate It may be also be used during NIV interruptions or after extubation
Recently an asymmetrical HFNC interface has been developed with a feature of one prong of smaller diameter and the other prong of larger diameter resulting in an increase in the overall cross-sectional area compared to conventional HFNC interface An experimental study has shown that asymmetrical nasal cannula potentially increased positive end-expiratory pressure PEEP and enhanced carbon dioxide washout compared to conventional nasal cannula Different respective effects in terms of pressure resistance and dead space washout between the two types of cannulas may explain different results according to the population
The aim of this study is to evaluate the physiologic effects of asymmetrical nasal cannula and conventional nasal cannula on diaphragm and parasternal intercostal activity of breathing measured by ultrasound in patients with acute respiratory failure
Recent clinical practice guidelines recommended to use HFNC in patients with acute hypoxemic respiratory failure over conventional oxygen therapy COT and noninvasive ventilation NIV A landmark clinical study demonstrated that patients with acute hypoxemic respiratory failure who received HFNC had better survival than COT and NIV A systematic review and meta-analysis also demonstrated that HFNC significantly reduced escalation of respiratory support in patients with acute hypoxemic respiratory failure
HFNC can also be an alternative respiratory support in patients with acute on chronic hypercapnic chronic obstructive pulmonary disease COPD Several physiological and clinical studies in COPD patients with exacerbations have also suggested that HFNC was not inferior to noninvasive ventilation NIV in COPD patients with mild to moderate exacerbation in terms of gas exchange treatment failure intubation rate and mortality rate It may be also be used during NIV interruptions or after extubation
Recently an asymmetrical HFNC interface has been developed with a feature of one prong of smaller diameter and the other prong of larger diameter resulting in an increase in the overall cross-sectional area compared to conventional HFNC interface An experimental study has shown that asymmetrical nasal cannula potentially increased positive end-expiratory pressure PEEP and enhanced carbon dioxide washout compared to conventional nasal cannula Different respective effects in terms of pressure resistance and dead space washout between the two types of cannulas may explain different results according to the population
The aim of this study is to evaluate the physiologic effects of asymmetrical nasal cannula and conventional nasal cannula on diaphragm and parasternal intercostal activity of breathing measured by ultrasound in patients with acute respiratory failure
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None