Effects on PaCO2 Levels of Two Different Nasal Cannula in COPD Patients (CODUET)

Scientific Institute for Research Hospitalization and Healthcare (IRCCS)

Status: Completed

Conditions: Chronic Obstructive Pulmonary Disease

Treatments: Device: AIRVO 2, with conventional symmetric nasal cannula; Device: AIRVO 2, the new asymmetric nasal cannula

Study type: Interventional

Funder types: Other

Identifiers

NCT05528289

n° 174/2022/Disp/AOUBo

Details and patient eligibility

About

High-flow nasal cannula (HFNC) therapy is increasingly used in the management of acute respiratory failure. Its clinical application has been expanded also in other specific settings In stable COPD patients and in those recovering from acute exacerbation, HFNC can reduce PaCO2, respiratory rate, minute ventilation and respiratory effort.

The aim of this randomized crossover physiological study is to investigate the effects on PaCO2 levels of two different nasal cannula ('Optiflow + Duet' interface vs "standard" nasal interface) in COPD patients with persistent hypercapnia following an acute severe exacerbation

Enrollment: 20 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Inpatients recovering from an acute exacerbation of their disease
• Persisting hypercapnia, despite having reached a stabilization in pH (i.e. pH>7,35 and
• PaCO2>50 mmHg on 3 consecutive measurements)
• Informed consent

Exclusion criteria

• Body Mass Index (BMI) > 30 kg/m2;
• Previous diagnosis of Obstructive sleep apnea syndrome (OSAS)
• Chest wall disease
• Heart failure
• Severe hemodynamic instability ( need for amine support)
• Acute coronary syndrome (ACS)
• Severe arrhythmia
• Renal insufficiency
• Patients unable to protect respiratory airways
• Respiratory arrest and need for endotracheal intubation
• Pregnancy
• Need for sedation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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20 participants in 2 patient groups

HFNC 40 L/min with conventional symmetric nasal cannula

Active Comparator group

Description:

The patients will be asked to breathe with HFNC at flow of 40 L/min with standard interface

Treatment:

Device: AIRVO 2, the new asymmetric nasal cannula

HFNC 40 L/min with new asymmetric nasal cannula

Active Comparator group

Description:

The patients will be asked to breathe with HFNC at flow of 40 L/min with the new asymmetric nasal cannula

Treatment:

Device: AIRVO 2, with conventional symmetric nasal cannula