Comparison of a new device for oxygen therapy with continuous positive airway pressure in healthy volunteers

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High flow oxygen therapy through nasal cannula (HFNC) is increasingly used in different clinical situation to assist patients with acute respiratory failure. HFNC is characterized by a low dilution of the administered gas with room air, a dead-space wash out of the upper respiratory airways and the application of a positive end-expiratory pressure (PEEP). However, PEEP is strictly limited to the during the expiration phase of the respiratory cycle, while during inspiration pharyngeal pressure drops to zero or even to negative values. This could be a limitation in case of hypoxemic acute respiratory failure (hARF), because recruitment of lung regions with atelectasis is not assured during the whole respiratory cycle. With continuous positive airway pressure (CPAP), the patient’s airway is maintained throughout the respiratory cycle at a selected constant pressure (PEEP), which is higher than the atmospheric pressure. Among the available interfaces, the helmet has been suggested to be effective in improving patient tolerance allowing more prolonged application of continuous CPAP. However, the heated humidification with helmet is problematic, difficult or almost or impossible because of condensation of water inside the interface ("fog" effect). We therefore designed a new interface joining HFNC with CPAP through helmet, to combine the physiological benefit of these two interfaces. We aim to assess airway pressures during the use of this new device with different gas flows and breathing conditions (primary endpoint). We will also assess the effects of different interfaces on the respiratory drive and effort of the subjects.

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