NIV & Glottis-diaphragm Synchrony

Status Recruiting

Clinical Trial Summary

Noninvasive ventilation (NIV) can provide ventilatory support in selected patients with acute respiratory failure, for instance due to acute exacerbation of COPD and acute heart failure. Advantages of noninvasive ventilation compared to invasive mechanical ventilation include absence of complications associated with endotracheal intubation, lower risk of pneumonia, lower level or even absence of sedation and the ability of the patient to verbally communicate. However, in approximately 30% of patients NIV fails and endotracheal intubation is needed to provide optimal ventilatory support. Surprisingly, very few studies have investigated why patients fail on NIV. Clinical observations indicated that agitation, delirium and most importantly asynchrony between patient and ventilator play a role in unsuccessful support with NIV. The upper airways are bypassed during endotracheal intubation. However, with NIV the upper airways may play a role in the efficiency of ventilatory support. In normal breathing the upper airways actively dilate before initiation of inspiratory flow. This is a highly appropriate response as it prevents narrowing of the upper airways during inspiration, which would result in elevated inspiratory resistance. Experiments in newborn lambs have shown that NIV has profound effects on physiology of the upper airways. Positive pressure during inspiration results in constriction of upper airway muscles in the early phase of inspiration. This results in elevated upper airway resistance with lower tidal volume delivered to the lungs. Subsequent studies revealed that reflexes that mediate this response originate in vagal afferences located in the lower airways. From an evolutionary point of view this might be an appropriate response, as high pressure delivered to the lungs may induce barotraumas. However, these responses may negatively affect the efficiency of ventilatory support delivered during NIV. The understanding of upper airway constriction and dilation during NIV is rudimentary. This study aims at determining the effect of NIV on regulation of upper airway patency in patients with COPD.

Clinical Trial Description

n/a

Study Design

Observational Model: Case-Only, Time Perspective: Prospective

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT01791335
Study type	Observational
Source	University Medical Center Nijmegen
Contact	L Heunks, MD PhD
Phone	0243617273
Email	l.heunks@ic.umcn.nl
Status	Recruiting
Phase	N/A
Start date	October 2012

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See also
Status	Clinical Trial	Phase
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Recruiting	`NCT05008211` - Information-Motivation-Behavioral Skills Model-based Intervention to Domiciliary Non-invasive Ventilation of Patients	N/A
Completed	`NCT03250416` - Management of Noninvasive Ventilation in Hypoxemic Patients
Not yet recruiting	`NCT03687385` - The Effect of High-flow Nasal Oxygenation to the Saturation During Analgo-sedation in Different ASA Risk Class Patients	N/A
Not yet recruiting	`NCT03687424` - Can High-flow Nasal Oxygenation Improve Oxygen Saturation During Analgo-sedation in Obese Adults?	N/A
Recruiting	`NCT04165382` - Development, Implementation and Evaluation of a Clinical Practice Guideline for Care of Preterm Infants Receiving Non-invasive Ventilation (NIV)	N/A
Completed	`NCT04912544` - Facilitating Patient Communication During Noninvasive Ventilation	N/A
Active, not recruiting	`NCT03499470` - Structured Discharge and Follow-up Protocol for COPD Patients Receiving LTOT and NIV	N/A
Not yet recruiting	`NCT05964244` - Impact of Noninvasive With Expiratory Washout on Respiratory Rate of Patients With Acute Hypercapnic Respiratory Failure	N/A
Recruiting	`NCT03053973` - The Effects of Nocturnal Non-invasive Ventilation in Stable COPD	N/A
Terminated	`NCT04413643` - NIV for COPD: Hospital to Home	N/A
Completed	`NCT03151317` - Effects of a Therapeutic Education Program on Treatment Adherence Among Patients Prescribed At-home CPAP or At-home NIV
Completed	`NCT03607357` - High Flow Nasal Oxygen and Acute Left Heart Failure	N/A
Withdrawn	`NCT02615834` - Chest Pressure for Intubated Peds Patients	N/A
Not yet recruiting	`NCT02383719` - Mask Comfort Feasibility	N/A
Not yet recruiting	`NCT06260202` - Nutrition Under Noninvasive Ventilation
Completed	`NCT03876873` - Effect of Head Rotation on Efficacy of Face Mask Ventilation in Anesthetized Obese (BMI ≥ 35) Adults	N/A
Completed	`NCT02267291` - Impact of Non-invasive Positive Pressure Ventilation on Cardiac Function and Echocardiographic Parameters	N/A
Not yet recruiting	`NCT04904484` - A Safety Assessment of the iZephyr Hood for NIV in COVID-19 Patients	N/A
Completed	`NCT03203577` - Initiation of Home Mechanical Ventilation at Home in Patients With Chronic Hypercapnic Respiratory Failure	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

NIV and Glottis-diaphragm Synchrony

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms