Analysis of Non-invasive Ventilatory Support Modes: High Flow Nasal Cannula and Non-invasive Ventilation

NCT04033666 — Not applicable, Unknown, 50 participants, University of Nove de Julho

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Comparative Analysis of Non-invasive Ventilatory Support Modes: High Flow Nasal Cannula and Non-invasive Ventilation in Acute Asthmatic Children

RegistryNCT04033666
StatusUnknown
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: double, treatment
Enrollment50 (Estimated)
SponsorUniversity of Nove de Julho (Other)
ConditionsAsthma Acute
InterventionsHigh Flow Nasal cannula, NIV Noninvasive Ventilation (Other)
Datesstart 2019-01-10, primary completion 2019-07-30 (estimated), completion 2019-11-30 (estimated), first posted 2019-07-26, last updated 2019-07-26
Locations1 site in Brazil

Related Papers Related Patents Related Grants Related Experts
All trials for Asthma Acute All trials of High Flow Nasal cannula All trials of NIV Noninvasive Ventilation

-Summary

This study compares two types of noninvasive treatments for asthma attacks with the objective of analyzing the efficacy of each therapy during the period of exacerbations in infants and asthmatics hospitalized.

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+Detailed description

A randomized clinical trial, where it will be established, treatment in hospitalized asthma patients in the infirmary and Emergency Room of the Hospital Infantil Cândido Fontoura.

The children eligible for the Protocol, after signing the terms of consent and assent, will be randomized for treatment in 2 groups (GI - bilevel and GII - High Flow Nasal Cannula). After the evaluations are started: Feb1, Volume expired in the first second; Peak Flow, vital signs and calculated Pulmonary Asthma Score, Pulmonary Asthma Severity Score, Pulmonary Index Score, and therapy application. The N to be considered for the study of 20 individuals per group. Group therapy I will be applied in diaphragmatic re-education exercises 3 x 10 breaths, after non-invasive ventilation, with parameters 12 cm H2O Ipap and Epap 8 cm H2O, for 45 minutes, according to patient tolerance, interface, with full face mask After treatment, reassessment of vital signs and measurements of Peak Flow, Fev1 and Severity Scores.

The GII will be established therapy with high-flow nasal cannula with dosage and cannula calculated according to the child's weight and respiratory rate at the time of evaluation, ranging from 2 l / min to 30 l / min. flow. The therapy will begin with diaphragmatic exercises 3 x 10 breaths, after 45 minutes of the installation of the therapy that is continuous, will be performed a reassessment of vital signs and Peak Flow, Feb, Severity Scores.

During the hospitalization time of the child will be carried out the daily treatment, therapy chosen for each patient for 45 minutes in the case of GI and the GII group daily follow-up and adjustment of flow dosage, also evaluated the vital signs, vital signs and Peak Flow, Feb, Gravity Scores.

At the time of hospital discharge, the evaluations will be performed and data such as inhaled corticosteroid use, oxygen use in days and inspired fraction, hospitalization days, hospital costs, as well as vital signs, vital signs and Peak Flow, Fev, Scores of Gravity.

+Arms and interventions

ArmTypeInterventionsDescription
High Flow nasal cannulaActive comparatorOther: High Flow Nasal cannulaIt will be administered as part of the high-flow nasal cannula treatment to reduce the symptoms of acute asthma
NIV noninvasive ventilationActive comparatorOther: NIV Noninvasive VentilationIt will be administered as part of the Noninvasive ventilation treatment to reduce the symptoms of acute asthma
  • High Flow Nasal cannula (Other), also known as HFNC: The HFNC will be instituted therapy with high-flow nasal cannula with dosage and cannula calculated according to the child's weight, ranging from 2 l / min to 30 l / min. The therapy will begin with diaphragmatic exercises 3x10 breaths and after high-flow therapy with nasal cannula for 45 minutes, after which will be performed the vital signs evaluations and Peak Flow, HRV, FEV1.
  • NIV Noninvasive Ventilation (Other), also known as NIV: The Therapy consisted of 3x10 diaphragmatic re-education exercises after a Bipap device was coupled in bipedal mode with parameters Ipap 12 cm H2O and Epap 8 cm H2O, for 45 minutes, according to the patient's tolerance, with Full face facial mask. After therapy evaluated vital signs and measures of Peak Flow, HRV, FEV1.

+Outcome measures

Primary outcomes

  • PAS Pediatric Asthma Score [Change from baseline PAS at first 45 minutes and 5th day in hospital]: PAS Pediatric Asthma Score- This score assesses respiratory distress and wheezing. Higher score the more severe the asthma attack. The score ranges from 3 to 15 and clinical improvement is expected when there is a reduction of 3 points or more.
  • Suplemental Oxigen day use [Change from baseline Oxygen dose at first 45 minutes and 5th day in hospital.]: Oxigen dose number of days used

Secondary outcomes

  • Forced Expiratory volume in first second [Change from baseline FEV1 at first 45 minutes and 5th day in hospital.]: FEV1 liters and percentage
  • Bronchodilator doses ( Salbutamol) [Change from baseline Salbutamol dose (First day and 5th day in hospital)]: Amount of puffs administered per day

+Eligibility

Sex: All, ages: 5 Years to 16 Years

Inclusion Criteria:

* Age between 5 and 16 years;
* both genders;
* Be in the presence of the bronchospasm crisis;
* Be admitted to HICF Hospital;
* Have signed the search terms

Exclusion Criteria:

* Having associated heart disease;
* neurological/cognitive impairment;
* Have severe respiratory insufficiency detected by severity scores;
* Intolerance to any type of treatment

+Locations (1)

FacilityCityCountryStatus
Nove de Julho UniversitySão PauloBrazil

+Publications

  • Results publication: David MMC, Gomes ELFD, Cavassini CLF, Luiz JG, Costa D. Comparison of the effects of high-flow nasal cannula and bilevel positive airway pressure treatments as respiratory physiotherapy interventions for children with asthma exacerbation: a randomized clinical trial. Einstein (Sao Paulo). 2024 Aug 26;22:eAO0588. doi: 10.31744/einstein_journal/2024AO0588. eCollection 2024. PMID 39194097

+Investigators

  • Dirceu Costa, Principal investigator, University of Nove de Julho