Pulmonary Hypertension
Conditions
Keywords
High-flow nasal cannula therapy, Hemodynamic monitoring, Echocardiography, right heart catheterization
Brief summary
In this study, the investigators aim to describe the hemodynamic consequences of nasal high-flow measured during right heart catheterization and echocardiography. The research hypothesis is that nasal high-flow would increase cardiac output in patients with pulmonary hypertension. The concomitant echocardiography will allow to describe its sensibility to detect cardiovascular consequences of nasal high-flow.
Interventions
DEVICENasal high-flow
Nasal high-flow is a respiratory technique which allows the administration of warmed and humidified air, associated with oxygen if necessary
Sponsors
ADIR Association
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
All patients will be randomly allocated into two groups using the block randomization technique (4 or 8 according to an equiprobable distribution) in a 1:1 ratio. The randomisation will be performed at the begining of the catheterization procedure. In the first arm, the patient will successively receive 30 L/min then 50 L/min of room air. In the second arm, the patient will successively receive 50 L/min then 30 L/min of room air.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- patient addressed for right heart catheterization for pulmonary hypertension suspicion or follow-up.
Exclusion criteria
* necessity of FiO2 \>21% during right heart catheterization * intracardiac shunt * grade 4 tricuspid insufficiency * complete arrhythmia due to atrial fibrillation * Pregnant or breastfeeding women or women of childbearing age without an effective method of contraception * protected adult patient (tutorship or curatorship) * patient deprived of liberty by court or administrative decision * refusal of patient participation or consent * patient for whom the measurement of pulmonary arterial pressures during right heart catheterization is impossible * patient for whom, during the etiological assessment of pulmonary hypertension, the diagnosis of precapillary pulmonary hypertension cannot be confirmed and classified in groups 1, 3 or 4.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cardiac output | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 30 and 50 L/min |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Right atrial pressure | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| systolic pulmonary arterial pressure | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| diastolic pulmonary arterial pressure | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| mean pulmonary arterial pressure | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| capillary wedge pressure | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| pulmonary vascular resistance | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| central venous oxygen saturation | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| heart rate | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| systolic arterial pressure | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| cardiac output | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| mean arterial pressure | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| systolic ejection volume | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| respiratory rate | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| pulse oxygen saturation | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
| Consequences of nasal high-flow 50 and 30 L/min FiO2 21% on echocardiographic parameters. | During the intervention, at isotime | Cardiac output, inferior vena cava diameter and collapsibiliy, systolic pulmoanry arterial pressure, tricuspid regurgitation velocity,tricuspid annular plane systolic excursion, right ventricule strain, tricuspid S wave, right on left ventricular telediastolic surface ratio, left ventricular ejection fraction, mitral doppler, mitral S wave, respiratory variability of E mitral wave |
| systolic pulmonary arterial pressure measured by catheterization and echocardiography. | During the intervention, at isotime | Concordance and correlation of hemodynamic parameters measured by catheterization and echocardiography. |
| capillary wedge pressure measured by catheterization and echocardiography. | During the intervention, at isotime | Concordance and correlation of hemodynamic parameters measured by catheterization and echocardiography. |
| right atrial pressure measured by catheterization and echocardiography. | During the intervention, at isotime | Concordance and correlation of hemodynamic parameters measured by catheterization and echocardiography. |
| cardiac output measured by catheterization and echocardiography. | During the intervention, at isotime | Concordance and correlation of hemodynamic parameters measured by catheterization and echocardiography. |
| diastolic arterial pressure | During the intervention, at isotime | Changes measured during cardiac catheterization under nasal high-flow 50L/Min FiO2 21% as compared to room air |
Countries
France
Contacts
Primary ContactElise ARTAUD-MACARI, MD
Backup ContactMaryline LEFORT, RT
Outcome results
None listed