Evaluation of the Effects on Carbon Dioxide (paCO2) of a New Oronasal Mask in Patients With Severe COPD Exacerbation Requiring Non-Invasive Mechanical Ventilation

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorIRCCS Azienda Ospedaliero-Universitaria di Bologna

About this trial

This single-center, crossover study aims to investigate the effects of the new OptiNIV oronasal mask used during NIV in COPD patients with respiratory acidosis following an exacerbation. The goal is to evaluate whether the clinical benefits, in terms of reducing PaCO2 levels, are greater with the new mask compared to a traditional one (Visairo Mask).

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age ≥ 18 years

Informed consent obtained

Patients with COPD and acute hypoxemic-hypercapnic respiratory failure (pH < 7.35, PaO₂ < 60 mmHg, PaCO₂ > 45 mmHg) requiring non-invasive mechanical ventilation.

Disqualifiers

BMI ≥ 30 kg/m²

Obstructive sleep apnea syndrome

Neuromuscular diseases or chest wall pathologies

Need for intubation and invasive mechanical ventilation during exacerbation

Trial design

Design model

Crossover

Treatments tested in this trial

  • OptiNIV

    Device

    Patients assigned to the "OptiNIV" group will be submitted to two consecutive 60-minute sessions. In the first session, they will receive NIV with an "optimized" mask (OptiNIV) and in the second session they will receive NIV with a traditional" oronasal mask (Visairo). The study will follow a crossover design, meaning each patient will undergo both sessions, In both sessions, NIV will be delivered using the same ventilator (ASTRAL 150 - ResMed Europe). Ventilator settings will be set to ensure the most effective ventilation and the best comfort for each patient. However, these settings must remain unchanged during the two sessions. A 30-minute washout period is planned between the sessions, during which patients will receive traditional oxygen therapy through a Venturi mask. The 30 min wash-out periodod can be extended until PtCO₂ returns within ±2 mmHg of baseline or until 60 minutes have passed. The maximum total treatment time for each patient will be approximately 3 hours.

  • Visairo

    Device

    Patients assigned to the "Visairo" group will be submitted to two consecutive 60-minute sessions. In the first session, they will receive NIV with a "traditional" oronasal mask (Visairo) and in the second session they will receive NIV with an "optimized" mask (OptiNIV). The study will follow a crossover design, meaning each patient will undergo both sessions. In both sessions, NIV will be delivered using the same ventilator (ASTRAL 150 - ResMed Europe). Ventilator settings will be set to ensure the most effective ventilation and the best comfort for each patient. However, these settings must remain unchanged during the two sessions. A 30-minute washout period is planned between the sessions, during which patients will receive traditional oxygen therapy through a Venturi mask. The 30 min wash-out periodod can be extended until PtCO₂ returns within ±2 mmHg of baseline or until 60 minutes have passed. The maximum total treatment time for each patient will be approximately 3 hours.

Treatment groups

21 Participants
are divided into 2 treatment groups
Group A: OptiNIVExperimental treatment 1 intervention
Group B: VisairoActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Evaluation of the effects of the OptiNIV oronasal mask on partial pressure of carbon dioxide (PaCO₂) levels in patients with severe COPD exacerbation requiring treatment with non-invasive mechanical ventilation.

Measured through arterial blood gas analysis. Unit of measurement: mmHg

Time frame
T0 (baseline), T1 ( + 1 hour), T2 ( + 2 hours), T3 (+ 3 hours).

Secondary outcomes

1

Evaluation of changes in paO2

It will be measured through arterial blood gas analysis Unit of measuremet: mmHg

Time frame
T0 (baseline), T1 ( + 1 hour), T2 ( + 2 hours), T3 (+ 3 hours).
2

Evaluation of changes in HCO3-

It will be measured through arterial blood gas analysis

Time frame
T0 (baseline), T1 ( + 1 hour), T2 ( + 2 hours), T3 (+ 3 hours).
3

Evaluation of changes in pH

It will be measured through arterial blood gas analysis

Time frame
T0 (baseline), T1 ( + 1 hour), T2 ( + 2 hours), T3 (+ 3 hours).
4

Evaluation of changes in PaO₂/FiO₂

It will be measured through arterial blood gas analysis

Time frame
T0 (baseline), T1 ( + 1 hour), T2 ( + 2 hours), T3 (+ 3 hours).

Other outcomes

Sponsors and contacts

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IRCCS Azienda Ospedaliero-Universitaria di Bologna

Lead sponsor

University of Bologna

Collaborator

Fisher and Paykel Healthcare

Collaborator

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