High Flow Nasal Oxygenation for General Thoracic Patients during Diagnostic Bronchoscopy. Comparison of conventional methods of respiratory support during bronchoscopy vs. High Flow Nasal Cannula.

General thoracic patients undergoing diagnostic bronchoscopy receiving High Flow oxygen therapy for respiratory support vs. conventional low flow oxygen therapy for respiratory support to reduce recovery/hospital time and maintain lung volumes

Status

Completed

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12615000206527

Enrollment

Registered

2015-03-03

Start date

2016-04-06

Completion date

2017-03-10

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

High flow oxygen therapy has been successfully trialled in a multitude of clinical scenarios. High flow oxygen therapy is known to provide more support than standard methods of oxygen delivery. This study aims to trial and assess the use of high flow as respiratory support during bronchoscopy as an alternative method to standard practice. We aim to establish whether high flow maintains end expiratory lung volume and improves other physiological parameters.

Interventions

Nasal high flow oxygen therapy has been widely investigated in many areas of in-hospital patient care. It can deliver up to 60L/min of humidified air and oxygen. Documented mechanisms of action for high flow include dead space clearance and washout, splinting of the upper airway and maintaining pulmonary conductance and compliance. Participants undergoing diagnostic bronchoscopy will be deemed 'high' or 'low' risk by treating anaesthetist, as per standard practice at this institution. 'Low' risk participants will receive light sedation and local anaesthetic for their bronchoscopy. Participants in this group will be randomised to receive either High Flow nasal cannula oxygen therapy at 60L/min or standard practice low flow oxygen therapy via nasal cannula or bite block (decision on nasal cannula vs. bite block will be at the discretion of the treating physician) for the duration of their bronchoscopy procedure and in recovery. Observational 'High' risk participants will receive general anaesthesia and a dedicated airway (LMA). Standard oxygen therapy will be administered during recovery. Study period will be approximately two hours for procedure and recovery time. Time will vary depending on bronchoscopy findings. Continuous haemodynamics, pharyngeal pressures and electrical impedance tomography, specifically end expiratory lung volumes, will be monitored. Additionally, time in and out of recovery will be documented as well as patient/staff satisfaction survey recorded.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Treatment

Masking

Open (masking not used)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

1. Eighteen (18) years + 2. Routine bronchoscopy in general thoracic patients 3. Able to give informed consent

Exclusion criteria

1) Unable to give informed consent 2) Transbronchial biopsy 3) Markedly deviated septum 4) Sinus problems or nasal trauma 5) Aspiration risk (pre-existing gastroparesis or known severe GORD) 6) Chest circumfrence larger than the Electrical Impedance Tomography belt. 7) Reduced level of consciousness 8) Pneumothorax (or within the last 2 weeks) 9) Not suitable for high flow nasal cannulae or pharyngeal catheter due to recent surgery and/or epistaxis.

Outcome results