Efficacy of Temporary Positive Expiratory Pressure (TPEP) in Chronic Hypersecretion (UNIKO)
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Purpose
Mechanical devices to increase the individual's bronchial hygiene are commonly used in patients with chronic retention of secretions and abnormal cough reflex. In this clinical context a new technology (namely TPEP® - Temporary Positive Expiratory Pressure) has been recently developed with the aim to improve the respiratory condition in patients suffering from chronic respiratory diseases. This trial has the aim to assess the clinical efficacy of TPEP in patients with chronic hypersecretion and airways obstruction, but with a normal competence of the cough reflex
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Hypersecretions |
Device: TPEP device (UNIKO) Procedure: MABT (Manually assisted breathing techniques) |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | Multicenter Controlled Trial on Efficacy of TPEP Device in Adult Patients With Chronic Hypersecretion |
- arterial oxygenation (as assessed by PaO2/FiO2 ratio and/or SatO2 index) [ Time Frame: Day 10 ] [ Designated as safety issue: No ]
- Sputum volume [ Time Frame: Day 1 to 10 ] [ Designated as safety issue: No ]
- Sputum characteristics [ Time Frame: Day 1 to 10 ] [ Designated as safety issue: No ]
- Individual's perceived sensation (VAS scale) [ Time Frame: Day 1 to 10 ] [ Designated as safety issue: No ]
- Lung function (volumes and respiratory muscle performance) [ Time Frame: Day 1 - 3 - 10 ] [ Designated as safety issue: No ]
| Enrollment: | 100 |
| Study Start Date: | July 2008 |
| Study Completion Date: | December 2010 |
| Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
TPEP added to conventional manually assisted breathing techniques (MABT)
|
Device: TPEP device (UNIKO)
This technique is mainly based on a continuous low-pressure insufflation in the airways, which is likely to reduce (or even avoid) the potential pressure-related damages of other commonly used devices. This device should be used only in those individuals who are showing a normal competence of their cough reflex, thus it should be considered as a means which may help those techniques normally adopted for the individual's bronchial hygiene.
Other Name: UNIKO
|
|
Active Comparator: 2
Manually assisted breathing techniques (MABT) alone
|
Procedure: MABT (Manually assisted breathing techniques)
Conventionally manually assisted breathing techniques
Other Name: MABT
|
Detailed Description:
This is a single-blind multicentre controlled randomized trial with consecutive recruitment. Randomization list by blocks will be available. Group comparison will be made between active therapies including TPEP added to conventional MABT (Intervention) or MABT alone (Control). Active therapy will last 10 consecutive daily sessions in both groups.
Primary outcome
Efficacy comparison on change in:
a.arterial oxygenation (as assessed by PaO2/FiO2 ratio and/or SatO2 index)
Secondary outcomes
Efficacy comparison on change in:
- Sputum characteristics
- Daily sputum volume
- Perceived sensation
- Lung functions (as assessed by spirometry and RM strength)
Eligibility| Ages Eligible for Study: | 25 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- chronic hypersecretion as defined by > 30 mL/die sputum production (7)
- chronic airway obstruction (by definition)
- COPD, bronchiectasis, asthma, cystic disease, etc. with or without chronic respiratory failure
- adulthood
- smoking or non-smoking habit
- Peak Cough Expiratory Flow > 150 L*min-1 (5)
- willingness to participate
Exclusion Criteria:
- childhood
- presence of acute exacerbation
- severe concomitant cardiovascular diseases
- concomitant neoplastic diseases
- non compliance/adherence to TPEP
- concomitant use of chronic mechanical ventilation
- use of amynophyllines and/or any active drugs (e.g. N-Acetyl-Cysteine)
Contacts and Locations| Italy | |
| Fondazione Maugeri IRCCS | |
| Lumezzane, Brescia, Italy | |
| Villa Pineta Hospital | |
| Pavullo nel Frignano, Modena, Italy, 41026 | |
| Fondazione Maugeri IRCCS | |
| Veruno, Novara, Italy | |
| Centro Riabilitazione Auxilium Vitae | |
| Volterra, Pisa, Italy | |
| Ospedale San Raffaele IRCCS | |
| Volterra, Roma, Italy, 00049 | |
| Ospedale San Giuseppe - Riabilitazione Specialistica | |
| Milano, Italy, 20100 | |
| Study Director: | Enrico M. Clini, MD | University of Modena - Villa Pineta Hospital |
| Study Chair: | Nicolino Ambrosino, MD | AOU Pisana - Cisanello (Pisa) |
More Information
No publications provided
| Responsible Party: | Prof. Enrico Clini, University of Modena - Villa Pineta Hospital |
| ClinicalTrials.gov Identifier: | NCT00700388 History of Changes |
| Other Study ID Numbers: | 69/08 |
| Study First Received: | June 17, 2008 |
| Last Updated: | August 2, 2011 |
| Health Authority: | Italy: National Monitoring Centre for Clinical Trials - Ministry of Health Italy: National Institute of Health |
Keywords provided by Villa Pineta Hospital:
|
Chronic bronchitis COPD Bronchiectasis |
ClinicalTrials.gov processed this record on May 16, 2013