DUET Versus Standard Interface for Hypercapnic COPD Patients

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorLarissa University Hospital

About this trial

The goal of this clinical trial is to compare the new asymmetric nasal high flow interface with the conventional high flow nasal cannula in patients with COPD exacerbation.

The main questions the study aims to answer are:

• Does the use of the asymmetric interface lead to:

1. A greater decrease in the patients' carbon dioxide 2. A greater decrease in respiratory rate and less dyspnea 3. Less need for advanced oxygen therapy measures 4. Same tolerance and comfort 5. Lower heart rate and blood pressure

Participants will be asked to:

Wear the asymmetric and conventional cannulas for 3 hours each with a 30 minute gap in-between. Arterial blood samples and various clinical parameters will be collected throughout the study period.

Researchers will compare the effect of asymmetric versus conventional cannulas to answer the aforementioned questions.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

acute exacerbation of COPD (defined as any worsening of the patient's respiratory symptoms that is beyond normal day-to-day variations and leads to change in medication)

mild-to-moderate acute hypercapnic respiratory failure (defined as 7.35>pH>7.25 and arterial CO2 tension (PaCO2) >45 mmHg)

Disqualifiers

acute on chronic hypercapnic respiratory failure

severe facial deformity, facial burns, fixed upper airway obstruction

indication for imminent intubation and invasive mechanical ventilation (i.e. respiratory or cardiac arrest, diminished consciousness (Glasgow coma score <8)

psychomotor agitation inadequately controlled by sedation

Trial design

Design model

Crossover

Treatments tested in this trial

  • Asymmetric nasal cannula - DUET

    Device

    DUET asymmetric nasal high flow interface that fits best to the patients' nostrils (size: one nostril of the patient should be fully occluded) Patients will be crossed-over between the 2 interventions

  • Conventional nasal high flow cannula

    Device

    Well-established conventional nasal high flow cannula (size: medium) Patients will be crossed-over between the 2 interventions

Treatment groups

50 Participants
are divided into 2 treatment groups
Group A: Hypercapnic COPD patient - Asymmetric or conventional nasal high flow cannulaExperimental treatment 2 interventions
Group B: Hypercapnic COPD patient - Conventional or asymmetric nasal high flow cannulaActive comparator 2 interventions

Trial outcomes

Primary outcomes

1

Arterial PCO2

Change in PCO2

Time frame
Immediately before and after the application of 3 hours of nasal high flow therapy (3 hours for each cannula type)

Secondary outcomes

1

Respiratory rate

Change in respiratory rate

Time frame
Immediately before and after the application of 3 hours of nasal high flow therapy (3 hours for each cannula type)
2

Invasive or non-invasive mechanical ventilation

Need for Invasive or non-invasive mechanical ventilation

Time frame
At the end of hospitalization (assessed up to 6 months), researchers will note if the patient needed invasive or non-invasive mechanical ventilation
3

Tolerance

Subjective tolerance of patients using visual analog scale (Score range: 0-10, higher scores indicate higher levels of tolerance)

Time frame
Immediately before and after the application of 3 hours of nasal high flow therapy (3 hours for each cannula type)
4

Comfort

Subjective comfort of patients using visual analog scale (Score range: 0-10, higher scores indicate higher levels of comfort)

Time frame
Immediately before and after the application of 3 hours of nasal high flow therapy (3 hours for each cannula type)

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Larissa University Hospital

Lead sponsor

Sotiria General Hospital

Collaborator