Pediatric ALL, Pulmonary Disease, Respiratory Disease
Conditions
Brief summary
This study will be used to evaluate and observe the overall performance and controls of the Helix ventilator. Pressure and flow data between participants' current devices and the Helix ventilator will be assessed in either invasive or non-invasive ventilation. To evaluate ventilator performance, pressure and waveform data will be assessed as well. Also, patient and caregiver feedback will be captured. The target population is infants to adults weighing more than 5kg. Participants will be recruited by Boston Children's Health Physician's Group. Up to thirty participants will be enrolled in the study.
Detailed description
Following the completion of the informed consent, participants enrolled in this study will be asked to use their existing ventilator for up to 1 hour to collect pressure and flow data for comparison purposes against the Helix ventilator. Participants will then be set up on the Helix Ventilatory System using the same mode of therapy as their current ventilator. Participants may receive mechanical ventilation using any patient circuit currently being designed for the Helix Ventilator (Passive, Active with Positive Airway Pressure (PAP), Active with Flow, or dual limb). Patients currently using non-invasive ventilation may be asked to use a mouth piece in lieu of a mask interface. While using the study device, therapy setting may be altered by the physician or his/her surrogate while maintaining the ventilator needs of the patient. For e.g.,a patient currently prescribed an synchronized intermittent mechanical ventilation (SIMV) mode may temporarily be switched to a pressure control mode to assess patient synchrony and ventilator performance. Once the participant is set-up, he/she will be asked to use the ventilator for up to 4 hours. During this time, Philips Respironics engineers will be collecting data through several mechanisms: 1) Helix SanDisc (SD) Card, 2) Non-invasive Cardiac Output (NICO) Monitoring System, and / or 3) External data collection device (ex. laptop). The study staff may ask the participant's opinions on the comfort of the therapy delivery. There will be no invasive monitoring as part of this study. The engineering evaluations will take place at the Boston Children's Health Physician offices. The study investigators, respiratory therapist, and/or other qualified clinical staff, will be supervising and present for all study visits. Philips Respironics engineers will be present for observational purposes only. All study staff working on this trial will be trained to the protocol and device prior to beginning work. Participants may be asked to participate in this data collection study up to six (6) times. Study data collected for this study will be collected on paper or electronic source records. These records will include information regarding inclusion/exclusion, performed study procedures and questions regarding device use. Only those staff that have been delegated by the Principal Investigator will be able to enter or make changes to the data in the Case Report Forms.
Interventions
The Helix ventilator is a non-FDA cleared ventilator device. The Helix ventilator has similar modalities to the Trilogy ventilator, which has FDA clearance. The Helix device has improved algorithms, controls, and features to enhance the therapy delivery. Additionally, Helix has an updated hardware platform which has been adequately tested to ensure that the device specifications are met. No pre-clinical or developmental clinical work was required because of Trilogy being the established predicate.
Sponsors
Study design
Intervention model description
This trial is an engineering study is to verify the overall performance and controls of the Helix Ventilator as compared to the participant's current therapy device.
Eligibility
Inclusion criteria
Participants who are currently using mechanical ventilation (\> 1 month at time of study participation) as part of medical care and have demonstrated a clinically acceptable response to this therapy and meet the following inclusion criteria: 1. Weight \> 5Kg; 2. Any medical condition requiring mechanical ventilation through nasal/facial mask, mouthpiece or tracheostomy 3. Any medical condition requiring mechanical ventilation for \> 1 month
Exclusion criteria
1. Participants intubated with an endotracheal tube 2. Clinically unstable, i.e., 1. Acute Respiratory Failure 2. Participants with refractory hypotension (defined as systolic blood pressure less than 90 mm Hg despite inotropic agents) 3. Uncontrolled cardiac ischemia or arrhythmias d. Any participant determined as inappropriate for the study by the Principal Investigator 3. Patients suffering from metastatic or terminal cancer 4. Currently employed by a manufacturer of respiratory products or family member employed by a manufacturer of respiratory products 5. Patient of surrogate is unable to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proximal Pressure From Trilogy Evo Ventilator and Current Device | 1 day | Proximal pressure from the participant's Trilogy Evo ventilator and current device |
| Proximal Flow From Trilogy Evo and Patient's Current Device | 1 day | Proximal flow from Trilogy Evo and patient's current device |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Subjective Ease-of-Operation Rating Regarding Trilogy Device | 1 day | Subjective Ease-of-Operation rating (1-Very Easy to 5-Very Hard) regarding Trilogy device |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Evaluable Population This population of non-invasive patients completed the engineering evaluation and utilized settings that allowed proper comparison between Trilogy and their current ventilator. | 13 |
| Non-Evaluable Population This population included N=2 invasive-ventilator patients, as well as N=1 who did not complete the engineering evaluation, and N=4 who were only included for the purposes of testing the updated leak algorithm. | 7 |
| Total | 20 |
Baseline characteristics
| Characteristic | Evaluable Population | Total | Non-Evaluable Population |
|---|---|---|---|
| Age, Continuous | 11.3 years STANDARD_DEVIATION 10.2 | 13.1 years STANDARD_DEVIATION 9.7 | 16.3 years STANDARD_DEVIATION 8.5 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 7 Participants | 7 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 6 Participants | 13 Participants | 7 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 2 Participants | 2 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 11 Participants | 15 Participants | 4 Participants |
| Region of Enrollment United States | 13 participants | 20 participants | 7 participants |
| Sex: Female, Male Female | 6 Participants | 11 Participants | 5 Participants |
| Sex: Female, Male Male | 7 Participants | 9 Participants | 2 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 20 |
| other Total, other adverse events | 0 / 20 |
| serious Total, serious adverse events | 0 / 20 |
Outcome results
Proximal Flow From Trilogy Evo and Patient's Current Device
Proximal flow from Trilogy Evo and patient's current device
Time frame: 1 day
Population: This population of non-invasive patients completed the engineering evaluation and utilized settings that allowed proper comparison between Trilogy and their current ventilator. It excludes N=2 invasive-ventilator patients, as well as N=1 who did not complete the engineering evaluation, and N=4 who were only included for the purposes of testing the updated leak algorithm.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Evaluable Population: Trilogy Evo | Proximal Flow From Trilogy Evo and Patient's Current Device | 4.2 Liters / minute | Standard Deviation 4.5 |
| Evaluable Population: Current Device | Proximal Flow From Trilogy Evo and Patient's Current Device | 4.9 Liters / minute | Standard Deviation 5.7 |
Proximal Pressure From Trilogy Evo Ventilator and Current Device
Proximal pressure from the participant's Trilogy Evo ventilator and current device
Time frame: 1 day
Population: This population of non-invasive patients completed the engineering evaluation and utilized settings that allowed proper comparison between Trilogy and their current ventilator. It excludes N=2 invasive-ventilator patients, as well as N=1 who did not complete the engineering evaluation, and N=4 who were only included for the purposes of testing the updated leak algorithm.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Evaluable Population: Trilogy Evo | Proximal Pressure From Trilogy Evo Ventilator and Current Device | 8.3 cm H2O | Standard Deviation 1.6 |
| Evaluable Population: Current Device | Proximal Pressure From Trilogy Evo Ventilator and Current Device | 8.2 cm H2O | Standard Deviation 3 |
Subjective Ease-of-Operation Rating Regarding Trilogy Device
Subjective Ease-of-Operation rating (1-Very Easy to 5-Very Hard) regarding Trilogy device
Time frame: 1 day
Population: This population of non-invasive patients completed the engineering evaluation and utilized settings that allowed proper comparison between Trilogy and their current ventilator. It excludes N=2 invasive-ventilator patients, as well as N=1 who did not complete the engineering evaluation, and N=4 who were only included for the purposes of testing the updated leak algorithm. Data not available from N=1 participant.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Evaluable Population: Trilogy Evo | Subjective Ease-of-Operation Rating Regarding Trilogy Device | 1.9 scores on a scale | Standard Deviation 0.8 |