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Evaluation of a Low-cost CPAP Device on Hospitalized COVID-19 Patients (OxyJet-CPAP)

B

Bangladesh University of Engineering and Technology

Status

Completed

Conditions

Covid19
Hypoxemia

Treatments

Device: High Flow Nasal Oxygen (HFNO) treatment
Device: Continuous Positive Airway Pressure (CPAP) therapy using OxyJet

Study type

Interventional

Funder types

Other

Identifiers

NCT04681859
BME-BUET-003

Details and patient eligibility

About

The aim of this study is to evaluate the preliminary safety and performance of a low-cost locally-made Venturi-based Non-invasive Positive Pressure Ventilator (NIPPV) device for hypoxemic COVID-19 patients. The device administers Continuous Positive Airway Pressure (CPAP) therapy using the jet-mixing or Venturi effect to increase the volume flow rate of oxygenated air from a pressurized cylinder by entraining the atmospheric air. To provide CPAP therapy, this high flow of oxygenated air is delivered to the patient via a low-cost non-vented mask with a tight seal with a High-Efficiency Particulate Air (HEPA) filter connected to the exhalation limb. The tight seal and HEPA filter ensures a minimal risk of aerosol generation and thus the device can be used without a negative pressure room. The system consists of the developed Venturi-based flow-generator, a standard 22mm breathing tube, a standard Y-connector, a non-vented CPAP mask (e.g., snorkel mask, helmet), a HEPA filter, and a Positive End Expiratory Pressure (PEEP) valve. The bench-top testing of the device is done in the laboratories of BUET and was verified that the device performs within the CPAP guidelines provided by the Medicines and Healthcare products Regulatory Agency (MHRA), UK. This study aims to assess the safety of and efficacy of the device in three different steps: (1) design validation, (2) clinical feasibility and (3) pilot clinical trial for safety and efficacy evaluation. Only if the device successfully passes the parts 1 and 2, the investigators will proceed to the final clinical trial in step 3. In this final step, the investigators aim to conduct a randomized controlled trial (RCT) evaluating for non-inferiority of the CPAP intervention compared to standard HFNO treatment. The number of ventilator-free days will be used as the primary outcome for efficacy, while patient recovery, death, or need of intubation and other adverse events will be used as secondary outcomes.

Enrollment

45 patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Age ≥ 18 years
  • Confirmed or suspected COVID-19 patient (by RT-PCR) having severe pneumonia and hypoxemia (SpO2 ≤90%) who did not respond to standard oxygen therapy (non-rebreather mask on 15L/min at 100% FiO2).

Exclusion criteria

  • Severely hypoxemic patients (SpO2≤85%)
  • Patients with low respiratory drive or requiring cardiopulmonary resuscitation
  • Patients with contraindications for CPAP
  • Pregnant status
  • Age > 65 years

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

45 participants in 2 patient groups

High Flow Nasal Oxygen (HFNO) treatment
Active Comparator group
Treatment:
Device: High Flow Nasal Oxygen (HFNO) treatment
Continuous positive airway pressure (CPAP) therapy using OxyJet
Experimental group
Treatment:
Device: Continuous Positive Airway Pressure (CPAP) therapy using OxyJet

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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