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Noninvasive Ventilation Masks Carbon Dioxide Clearance in Normal Volunteers

Carbon Dioxide (CO2) Clearance From Various Face Masks in Normal Volunteers at Various Level of Expiratory Positive Airway Pressure (EPAP) When Using a Non-Invasive Positive Pressure Ventilation (NIPPV)

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03882723
Enrollment
8
Registered
2019-03-20
Start date
2018-03-30
Completion date
2019-08-30
Last updated
2023-06-28

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

Conditions

CO2 Clearance, Mask Comfort, Rebreathing Exhaled Gas

Brief summary

This study will be a randomized crossover trial that will be conducted at Rush University. The study will be conducted with 20 healthy volunteers who will be placed on ICU ventilator operating in the NIPPV mode. All subjects will perform 15 minutes of breathing on NIPPV on each mask of the 4 different masks (2 oronasal and 2 full face masks) that are randomly selected. Breathing through each mask will be followed by a 5- minute wash out period between masks. End tidal Carbon Dioxide (EtCO2) will be sampled nasal/oral. Different levels of EPAP will be set and CO2 clearance will be monitored. Additionally, subjective mask comfort will be assessed via visual analog scale (VAS) with 1 referring to least comfortable and 5 being the most comfortable.

Detailed description

This study will be a randomized crossover trial that will be conducted at Rush University. Normal volunteers will be recruited from Rush University Medical Centers. Volunteers will be screened with inclusion and exclusion criteria and an informed consent is required in order for them to participate. Also, initial baseline vital signs (heart rate, blood pressure, respiratory rate, and oxygen saturation) will be obtained. EtCO2 will be obtained at baseline and periodically using an oral/nasal sample line with the CapnostreamTM 20p monitor (Medtronic, Minneapolis, MN). The study will use a double limb circuit ICU ventilator Puritan Bennett™ (Medtronic, Dublin, Ireland). Investigators will evaluate 4 NIPPV masks (2 oronasal masks and 2 full face masks). Oronasal masks will be labeled as group A and numbered as A1 and A2; while full face masks will be labeled group B and numbered as B1 and B2. Order of the masks will be randomly chosen in two steps. First steps will be choosing A or B then randomly assign mask in each of these groups. Investigators will randomly assign mask in group A or B by drawing an initial mask from the group and then continue the sequence of masks from that point. For example, investigators randomly chose group A, then randomly chose A2, the sequence will be A2, A1. Then Investigators would randomly choose B2, then the sequence would be B2, B1. All subjects will perform 15 minutes on each mask followed by 5 minutes wash out interval between masks. EPAP levels will be 0, 2, 4, & 5 while IPAP remains at 5 higher than EPAP. EtCO2 will be collected at 4:00, 4:30 and 5:00 minute mark. These three measures should differ by less than 20% of their average. Also, subjective mask ORA: 18011502-IRB01 Date IRB Approved: 3/30/2018 Amendment Date: 5/11/2018 comfort will be assessed via visual analog scale (VAS) with 1 referring to least comfortable and 5 being the most comfortable after 5 each EPAP setting.

Interventions

DEVICEEvaluated 4 masks used for NIV with mechanical ventilators

Order of the masks (BiTrac MaxShield™ with standard elbow, BiTrac™ Full Face with standard elbow, Respironics PerforMax with standard elbow, and Respironics AF531 with standard elbow) were randomly chosen. Investigators randomly assigned all masks for paper raffling from container. All subjects performed 20 minutes on each mask followed by 5 minutes wash out interval between masks. EPAP levels will be 0, 2, 4, & 5 (5 minutes for each level) while IPAP remains at 5 higher than EPAP. FiCO2 and EtCO2 were collected at 4:00, 4:30 and 5:00 minute mark for each EPAP level. Also, subjective mask comfort was assessed via visual analog scale (VAS) with 1 referring to least comfortable and 5 being the most comfortable after 5 each EPAP setting.

Sponsors

Rush University Medical Center
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Intervention model description

randomized crossover trial

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

* Healthy subjects greater than 18 years old.

Exclusion criteria

* Prior history of NIPPV as a patient. * Facial surgery or deformity * Ear infection * History of pulmonary or cardiac disease

Design outcomes

Primary

MeasureTime frameDescription
Carbon Dioxide Clearance From the Masks5 minMeasured the percentage of CO2 being re-breathed or inspired using a nasal cannula and sidestream end-tidal CO2 monitor.

Secondary

MeasureTime frameDescription
Leak (L/Min)5 minAmount of leak measured by the ventilator.
Tidal Volume5 minutesTidal volume measured by the ventilator.
Respiratory Rate (BPM)5 minutesThe ventilator measured the subjects' respiratory rates.

Countries

United States

Participant flow

Pre-assignment details

This was a randomized crossover trial so each participate used all four masks (BiTrac MaxShield™ with standard elbow, BiTrac™ Full Face with standard elbow, Respironics PerforMax with standard elbow, and Respironics AF531 with standard elbow).

Participants by arm

ArmCount
Randomized Crossover Trial With 4 NIV Masks
Order of the masks (BiTrac MaxShield™ with standard elbow, BiTrac™ Full Face with standard elbow, Respironics PerforMax with standard elbow, and Respironics PerforMax with standard elbow) were randomly chosen. Investigators randomly assigned all masks for paper raffling from container. All subjects performed 20 minutes on each mask followed by 5 minutes wash out interval between masks. EPAP levels will be 0, 2, 4, & 5 (5 minutes for each level) while IPAP remains at 5 higher than EPAP. FiCO2 and EtCO2 were collected at 4:00, 4:30 and 5:00 minute mark for each EPAP level. Also, subjective mask comfort was assessed via visual analog scale (VAS) with 1 referring to least comfortable and 5 being the most comfortable after 5 each EPAP setting. Evaluated masks used for NIV with mechanical ventilators: Order of the masks were randomly chosen. Investigators randomly assigned all masks for paper raffling from container. All subjects performed 20 minutes on each mask followed by 5 minutes wash out interval between masks. EPAP levels will be 0, 2, 4, & 5 (5 minutes for each level) while IPAP remains at 5 higher than EPAP. FiCO2 and EtCO2 were collected at 4:00, 4:30 and 5:00 minute mark for each EPAP level. Also, subjective mask comfort was assessed via visual analog scale (VAS) with 1 referring to least comfortable and 5 being the most comfortable after 5 each EPAP setting.
8
Total8

Baseline characteristics

CharacteristicRandomized Crossover Trial With 4 NIV Masks
Age, Customized
greater than 18
8 Participants
No current ear infection8 Participants
no facial surgery or deformity that would interfere with the mask seal.8 Participants
No history of pulmonary or cardiac disease8 Participants
No history of use of noninvasive ventilation8 Participants
Race and Ethnicity Not Collected— Participants
Sex/Gender, Customized
Not collected
0 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 8
other
Total, other adverse events
0 / 8
serious
Total, serious adverse events
0 / 8

Outcome results

Primary

Carbon Dioxide Clearance From the Masks

Measured the percentage of CO2 being re-breathed or inspired using a nasal cannula and sidestream end-tidal CO2 monitor.

Time frame: 5 min

Population: The study protocol and statistical analysis planned to have this outcome measure be analyzed and reported per PEEP level, not per intervention. There were 8 participants and 4 masks, making 32 unique measures for each PEEP level. This pilot project aimed to identify that CO2 rebreathing existed when using a dual limb circuit. Individual mask data may misrepresent the issue and be inappropriately used for marketing purposes.

ArmMeasureValue (MEDIAN)
PEEP 0Carbon Dioxide Clearance From the Masks1.83 percentage of CO2 inspired
PEEP 2Carbon Dioxide Clearance From the Masks1 percentage of CO2 inspired
PEEP 4Carbon Dioxide Clearance From the Masks0.49 percentage of CO2 inspired
PEEP 5Carbon Dioxide Clearance From the Masks0 percentage of CO2 inspired
Secondary

Leak (L/Min)

Amount of leak measured by the ventilator.

Time frame: 5 min

Population: The study protocol and statistical analysis planned to have this outcome measure be analyzed and reported per PEEP level, not per intervention. There were 8 participants and 4 masks, making 32 unique measures for each PEEP level. This pilot project aimed to identify that CO2 rebreathing existed when using a dual limb circuit. Individual mask data may misrepresent the issue and be inappropriately used for marketing purposes.

ArmMeasureValue (MEDIAN)
PEEP 0Leak (L/Min)22 Liters per minute
PEEP 2Leak (L/Min)30 Liters per minute
PEEP 4Leak (L/Min)36 Liters per minute
PEEP 5Leak (L/Min)41 Liters per minute
Secondary

Respiratory Rate (BPM)

The ventilator measured the subjects' respiratory rates.

Time frame: 5 minutes

Population: The study protocol and statistical analysis planned to have this outcome measure be analyzed and reported per PEEP level, not per intervention. There were 8 participants and 4 masks, making 32 unique measures for each PEEP level. This pilot project aimed to identify that CO2 rebreathing existed when using a dual limb circuit. Individual mask data may misrepresent the issue and be inappropriately used for marketing purposes.

ArmMeasureValue (MEDIAN)
PEEP 0Respiratory Rate (BPM)13 breaths per minute
PEEP 2Respiratory Rate (BPM)15 breaths per minute
PEEP 4Respiratory Rate (BPM)15 breaths per minute
PEEP 5Respiratory Rate (BPM)15 breaths per minute
Secondary

Tidal Volume

Tidal volume measured by the ventilator.

Time frame: 5 minutes

Population: The study protocol and statistical analysis planned to have this outcome measure be analyzed and reported per PEEP level, not per intervention. There were 8 participants and 4 masks, making 32 unique measures for each PEEP level. This pilot project aimed to identify that CO2 rebreathing existed when using a dual limb circuit. Individual mask data may misrepresent the issue and be inappropriately used for marketing purposes.

ArmMeasureValue (MEAN)
PEEP 0Tidal Volume636 milliliters
PEEP 2Tidal Volume646 milliliters
PEEP 4Tidal Volume637 milliliters
PEEP 5Tidal Volume701 milliliters

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026