COPD
Conditions
Keywords
High flow nasal cannula oxygen, exercise performance, COPD
Brief summary
Ventilation limitation has a significant adverse effects on cardiovascular function and cerebral oxygenation during exercise in patients with COPD. High flow nasal cannula (HFNC) has been shown to improve ventilation by washing out the anatomical dead space and permitting a better gas exchanges. Moreover, it is able to ensure the desired inspired oxygen fraction (FiO2) even at high level of patient's minute ventilation by minimizing the room air entrainment. The effects of HFNC on exercise performance in terms of hemodynamic changes and exercise endurance in COPD patients remain unclear. The primary purpose of this study is to examine the effects of HFNC on the exercise endurance in COPD patients. The investigator's secondary purpose is to investigate whether HFNC could improve efficiency of ventilation, leading to an improvement of hemodynamic and cerebral oxygenation response.
Detailed description
This is a randomized crossover study. Patients who have been diagnosed as COPD will be recruited from outpatient department. After signing informed consent form, patients undertake an incremental exercise test and two constant load exercise at the 70% of maximum workload achieved at a previous incremental exercise test on arm ergometer in two separate days. The constant load tests will be performed with HFNC and with nasal cannula at the same inhaled oxygen fraction in random order. The hemodynamics CO, SV, EF of all subjects during exercises will be measured by a bioelectrical impedance device (Physioflow), and cerebral oxygenation status (oxygenated hemoglobin (O2Hb), deoxygenated hemoglobin (HHb), total hemoglobin (tHb) was measured by a near infrared spectrophotometer (NIRS).
Interventions
DEVICEhigh flow nasal cannula
High flow nasal cannula is a device that delivered heated and humidified high flow gases to at or near body temperature to avoid drying and possible injury to the nasal mucosa. In this study, subjects perform a constant-load exercise test with high flow nasal cannula.
DEVICEnasal cannula
Nasal cannula is a device that delivered oxygen to patients. In this study, subjects perform a constant-load exercise test with nasal cannula.
Sponsors
Chang Gung University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. with diagnosis of COPD 2. OPD patients 3. has no AE (within 1 month) 4. not receiving any O2 therapy at home 5. no smoking or quick
Exclusion criteria
1. fever 2. unstable hemodynamics at resting 3. orthopadeic or neurologic problems that limited exercise
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| exercise time with high flow nasal cannula | end of the exercise test in the session of constant-load exercise test with high flow nasal cannula oxygen device | the total duration that subjects performed constant-load exercise test with high flow nasal cannula oxygen device |
| exercise time with nasal cannula | end of the exercise test in the session of constant-load exercise test with nasal cannula oxygen device | the total duration that subjects performed constant-load exercise test with nasal cannula oxygen device |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Difference in cardiac output | Baseline and 48 hours after baseline ] | Difference in end-exercise cardiac output in constant-load exercise test between HFNCO and NC |
| Difference in stroke volume | Baseline and 48 hours after baseline ] | Difference in end-exercise stroke volume in constant-load exercise test between HFNCO and NC |
| Difference in muscle tissue oxygenation | Baseline and 48 hours after baseline ] | Difference in end-exercise muscle tissue oxygenation in constant-load exercise test between HFNCO and NC |
| Difference in cerebral tissue oxygenation | Baseline and 48 hours after baseline ] | Difference in end-exercise cerebral tissue oxygenation in constant-load exercise test between HFNCO and NC |
Countries
Taiwan
Outcome results
None listed