Comparison of Three Noninvasive Ventilation Modes: a Physiological Study in Healthy Volunteers
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Purpose
Noninvasive ventilation (NIV) is a well established, safe, and effective technique in improving gas exchange while reducing dyspnea and inspiratory effort in patients with either hypoxemic and hypercapnic acute respiratory failure (ARF) and averts the risk secondary to endotracheal intubation.Crucial factors for NIV success, in any forms of respiratory failure, are the tolerance to the interface used and the ability of the interface to unload inspiratory-muscle. Helmet is better tolerated over time, allowing continuous application of NIV for longer periods, while face mask has been proved to be more efficient at iso-support in unloading the respiratory muscles and improving patient-ventilator synchrony. Helmet NEXT (CaStar, NIV model, Starmed, Mirandola, Italy) is a novel type of helmet with a better compliant wall, that avoid the use of armpit braces potentially improving, compared to the standard helmet, both pressurization and patient-ventilator interaction and tolerance. The objective of this study is to compare the effects of NIV delivered via face mask, standard helmet, and NEXT helmet in terms of work of breathing, patient-ventilator interaction, and comfort.
| Condition | Intervention |
|---|---|
|
Respiratory Failure Non Invasive Ventilation on Healthy Volunteer |
Device: Non invasive ventilation HELMET Device: Non invasive ventilation facemask (Respironics) |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Supportive Care |
| Official Title: | Comparison of Helmet NEXT, Helmet Standard and Facemask for Noninvasive Ventilation: a Physiological Study in Healthy Volunteers |
- Work of breathing [ Time Frame: during the single visit study (day 1) ] [ Designated as safety issue: No ]To estimate the work of breathing, we will determine the swings in transdiaphragmatic pressure (Pdi) and the transdiaphragmatic pressure-time product (PTPdi)
- Ventilatory comfort [ Time Frame: during the single visit study (day 1) ] [ Designated as safety issue: No ]The comfort will be assessed by a self-assessment of the patient on a visual analog scale between 0 (excellent) and 10 (discomfort).
- Patient-ventilator asynchronies [ Time Frame: during the single visit study (day 1) ] [ Designated as safety issue: No ]The patient-ventilator asynchronies will be assessed by the asynchronie index (number of asynchronies / number of respiratory cycles). The number of asynchronies will be assessed by the investigator, on the records of the pression curves and the respiratory outputs.
- Ventilatory parameters [ Time Frame: during the single visit study (day 1) ] [ Designated as safety issue: No ]The respiratory frequency and current volume will be measured.
| Estimated Enrollment: | 16 |
| Study Start Date: | April 2012 |
| Estimated Study Completion Date: | August 2012 |
| Estimated Primary Completion Date: | August 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: HELMET
The HELMET and HELMET NEXT modes will be tested by each patient.
|
Device: Non invasive ventilation HELMET
The HELMET and HELMET NEXT modes will be tested by each patient.
|
|
Sham Comparator: Facemask
The facemask will be used by each patient.
|
Device: Non invasive ventilation facemask (Respironics)
The facemask Respironics (Herrsching, Germany) will be used by each patient.
|
Detailed Description:
16 Healthy volunteers will be enrolled. They will be ventilated with non invasive ventilation. The Work of breathing, ventilator/patient asynchrony, and ventilatory comfort produced between face mask, Helmet and NEXT helmet will be compared.
Eligibility| Ages Eligible for Study: | 18 Years to 60 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Healthy volunteers
Exclusion Criteria:
- contraindications for nasogastric tube placement
- Respiratory disease
- Pregnancy
- No French health insurance
Contacts and Locations| Contact: Samir Jaber, MD PhD | + 33 4 67 33 72 71 | s-jaber@chu-montpellier.fr |
| France | |
| Department of Anesthesiology & Critical Care, St Eloi University Hospital | Recruiting |
| Montpellier, France, 34000 | |
| Contact: Samir Jaber, MD PhD + 33 4 67 33 72 71 s-jaber@chu-montpellier.fr | |
| Principal Investigator: Samir Jaber, MD PhD | |
More Information
No publications provided
| Responsible Party: | University Hospital, Montpellier |
| ClinicalTrials.gov Identifier: | NCT01610960 History of Changes |
| Other Study ID Numbers: | 8937 |
| Study First Received: | May 24, 2012 |
| Last Updated: | June 1, 2012 |
| Health Authority: | France: Committee for the Protection of Personnes France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) |
Keywords provided by University Hospital, Montpellier:
|
Non invasive ventilation Helmet NEXT Helmet Work of breathing Intensive care |
Additional relevant MeSH terms:
|
Respiratory Insufficiency Respiration Disorders Respiratory Tract Diseases |
ClinicalTrials.gov processed this record on May 16, 2013