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Trial record 36 of 671 for:    CARBON DIOXIDE AND arterial

End Tidal Carbon Dioxide Monitoring for Evaluating Changes of PaCO2 After Noninvasive Mechanical Ventilation in COPD

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ClinicalTrials.gov Identifier: NCT01821365
Recruitment Status : Unknown
Verified April 2013 by ting Jiang, The First Affiliated Hospital of Guangzhou Medical University.
Recruitment status was:  Recruiting
First Posted : April 1, 2013
Last Update Posted : April 5, 2013
Sponsor:
Information provided by (Responsible Party):
ting Jiang, The First Affiliated Hospital of Guangzhou Medical University

Brief Summary:
Sidestream end-tidal CO2 has been found to be closely correlated to PaCO2 especially when people have the stable hemodynamics and normal lung function. PETCO2 can basically reflect the level of PaCO2,but some investigators found that PETCO2 measurements did not reflect PaCO2 in COPD patients.There may be several reasons for this discrepancy. Due to airway obstruction and ventilation-perfusion mismatch, there is a delay in the maximum alveolar concentration of CO2 reaching the cannula, which may give lower PETCO2 values compared with PaCO2. To overcome this disadvantage, we tried to prolong their expiratory time (extend to 5-8s) in order to guarantee adequate time for alveolar CO2 reaching the cannula.our study mainly focus on two issues.First, to explore the optimal depth of tube placed when patients with COPD breathe spontaneously or receive noninvasive ventilation, and compare the differences of two condition at the same time. Secondly, to evaluate the agreement between the PaCO2 and sidestream PETCO2(5s)values in COPD patients receiving noninvasive ventilation when our extension tube locates in the optimal position, and investigate whether PETCO2(5s)can be used to monitor ventilation status dynamically.

Condition or disease
COPD

Detailed Description:

Non-invasive positive pressure ventilation(NPPV) can significantly improve gas exchange and relieve respiratory muscle fatigue for COPD,and arterial blood gas is the gold standard to evaluate ventilation status,but the procedure is time consuming,invasive, painful and in some patients.

Sidestream end-tidal CO2 has been found to be closely correlated to PaCO2 especially when people have the stable hemodynamics and normal lung function. PETCO2 can basically reflect the level of PaCO2, but for patients with COPD, due to the presence of airway obstruction and emphysema formation, which cause ventilation-perfusion ratio(V/Q) , result to dead space-tidal volume ratio(VD/VT) and right-to-left shunting(Qs/Qt), the time of various lung units discharge of carbon dioxide is not synchronous. Some investigators found that PETCO2 measurements did not reflect PaCO2 in COPD patients. There may be several reasons for this discrepancy. Due to airway obstruction and ventilation-perfusion mismatch, there is a delay in the maximum alveolar concentration of CO2 reaching the cannula, which may give lower PETCO2 values compared with PaCO2. To overcome this disadvantage, we tried to prolong their expiratory time (extend to 5-8s) in order to guarantee adequate time for alveolar CO2 reaching the cannula.

our study mainly focus on two issues.First, to explore the optimal depth of tube placed when patients with COPD breathe spontaneously or receive noninvasive ventilation, and compare the differences of two condition at the same time. Secondly, to evaluate the agreement between the PaCO2 and sidestream PETCO2(5s)values in COPD patients receiving noninvasive ventilation when our extension tube locates in the optimal position, and investigate whether PETCO2(5s)can be used to monitor ventilation status dynamically.


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Study Type : Observational [Patient Registry]
Estimated Enrollment : 40 participants
Time Perspective: Prospective
Target Follow-Up Duration: 2 Days
Official Title: End Tidal Carbon Dioxide Monitoring for Evaluating Changes of Arterial Carbon Dioxide After Noninvasive Mechanical Ventilation in Chronic Obstructive Pulmonary Disease
Study Start Date : March 2013
Estimated Primary Completion Date : July 2013
Estimated Study Completion Date : July 2013



Primary Outcome Measures :
  1. the agreement and correlation between the partial pressure of end-tidal carbon dioxide(PETCO2) [ Time Frame: one day ]
    PETCO2 was measured by using sidestream capnometer though prolonged expiratory method(extend to 5s) , and obtained arterial blood sampling simultaneously.



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Ages Eligible for Study:   40 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients with a COPD exacerbation who admitted to the respiratory department of First Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong,China
Criteria

Inclusion Criteria:1.patients are enrolled in accordance with 2011 international treatment guidelines of COPD.

2.patients are in a clear state of mind and can incompliance with clinicians to extend breathing only using nose and closing mouth.

Exclusion Criteria:1.Hemodynamic instability. 2.Pulmonary embolism,Pneumothorax, pleural effusion, upper airway obstruction,Chest trauma, chest wall deformities, neuromuscular diseases, lung tumor.

3.combinating acute exacerbation of bronchial asthma in this hospitalization. 4.Nose and mouth trauma, deformity, or recent surgery.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01821365


Contacts
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Contact: rongchang Chen, MD 020-83062718 Chenrc99@163.com

Locations
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China, Guangdong
The First Affiliated Hospital of Guangzhou Medical University Recruiting
Guangzhou, Guangdong, China, 510120
Contact: Rongchang Chen, MD    020-83062718    Chenrc99@163.com   
Sub-Investigator: Ting Jiang, MM         
Sponsors and Collaborators
The First Affiliated Hospital of Guangzhou Medical University
Investigators
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Principal Investigator: Rongchang Chen, MD The First Affiliated Hospital of Guangzhou Medical University

Additional Information:

Publications of Results:

Other Publications:
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Responsible Party: ting Jiang, MM, The First Affiliated Hospital of Guangzhou Medical University
ClinicalTrials.gov Identifier: NCT01821365     History of Changes
Other Study ID Numbers: 2009CB522100
First Posted: April 1, 2013    Key Record Dates
Last Update Posted: April 5, 2013
Last Verified: April 2013
Keywords provided by ting Jiang, The First Affiliated Hospital of Guangzhou Medical University:
COPD,PETCO2,PaCO2