HFNC Flow Titration and Effort of Breathing in the PICU (HFNCandEOB)

Children's Hospital Los Angeles

Status: Completed

Conditions: High Flow Nasal Cannula

Treatments: Device: Vapotherm high flow nasal cannula; Device: Fisher & Paykel high flow nasal cannula

Study type: Interventional

Funder types: Other

Identifiers

NCT02793674

CHLA-14-00239

Details and patient eligibility

About

High-flow nasal cannula (HFNC) is a method of non-invasive respiratory support used to decrease the effort of breathing (EOB) in patients with a wide variety of respiratory diseases in the pediatric intensive care unit. While its use has shown association with decreased rates of mechanical ventilation, there is a paucity of data examining its direct effect upon objective measurements of EOB. This study will aim to evaluate objective measurements of EOB in response to different levels of HFNC support, characterize the natural course of respiratory diseases treated with HFNC, evaluate changes in EOB secondary to the administration of supplemental medical therapies used in conjunction with HFNC, and compare different physiologic metrics for quantifying EOB in patients on HFNC.

Enrollment: 21 patients

Sex: All

Ages: Under 3 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All participants less than or equal to three years old admitted to the PICU placed on high flow nasal cannula will be considered eligible for the study.

Exclusion criteria

• Participants will be excluded if they have a corrected gestational age less than 37 weeks or contraindications to nasoesophageal catheter placement (nasopharyngeal or esophageal abnormalities) or RIP bands (abdominal wall defects such as omphalocele). Patients greater than three years of age will be excluded.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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21 participants in 2 patient groups

Fisher & Paykel high flow nasal cannula

Other group

Description:

All participants in the study were on one or two high flow nasal cannula (HFNC) delivery systems. All were measured on the Fisher \& Paykel HFNC delivery system. The flow rate of the HFNC was adjusted to determine if there exists a change in their effort of breathing.

Treatment:

Device: Fisher & Paykel high flow nasal cannula

Vapotherm high flow nasal cannula

Other group

Description:

All participants in the study were on one or two high flow nasal cannula (HFNC) delivery systems. A subgroup was measured on the Vapotherm HFNC delivery system. The flow rate of the HFNC was adjusted to determine if there exists a change in their effort of breathing.

Treatment:

Device: Vapotherm high flow nasal cannula