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This study evaluates the work of breathing among healthy subjects under various conditions of treatment with high flow nasal cannulas. Ten subjects will be included. The design of this study is a cross over of five treatment periods with different flow settings.
High flow oxygen therapy (HFOT) is a promising technique increasingly used in the management of acute respiratory failure. In hospitalised hypoxemic patients, recent clinical evidence showed that HFOT can reduce endotracheal intubation and reduce mortality. Physiologically, the HFOT causes a decrease in respiratory rate and minute-ventilation and may be associated with a decrease in carbone dioxyde arterial pressure. It is possible that these effects are associated with decreased work of breathing, which could explain some of the benefits in terms of comfort and efficiency.
The objective of this research is to evaluate the impact of a wash-out of anatomical dead space by high flow nasal cannulas on respiratory parameters and on the work of breathing among healthy subjects. The investigators will evaluate the baseline status in room air, and then compare it with four different levels of flow. The primary endpoint will be the work of breathing.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| No flow | No Intervention | Subjects will be spontaneously breathing in room air with no flow. | |
| Conventional flow via nasal prongs | Experimental | Subjects will be breathing with nasal prongs delivering 5 L/min of air (inspired fraction of oxygen: 0.21) |
|
| High flow nasal cannulas 20 L/min | Experimental | Subjects will be breathing with high flow nasal cannulas delivering 20 L/min with an inspired fraction of oxygen of 0.21. |
|
| High flow nasal cannulas 40 L/min | Experimental | Subjects will be breathing with high flow nasal cannulas delivering 40 L/min with an inspired fraction of oxygen of 0.21. |
|
| High flow nasal cannulas 60 L/min | Experimental | Subjects will be breathing with high flow nasal cannulas delivering 60 L/min with an inspired fraction of oxygen of 0.21. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High flow nasal cannulas | Device | Comparison of different flow levels |
|
| Measure | Description | Time Frame |
|---|---|---|
| Work of breathing | Work of breathing at the end of each period is calculated from the measurement of esophageal pressure and tidal volume (composite outcome). | 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Esophageal pressure-time product | Measured at the end of each period | 10 minutes |
| Tidal Volume | Measured at the end of each period | 10 minutes |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mathieu Delorme, PT, MSc | Contact | 418-656-8711 | 3508 | mathieu.delorme.2@ulaval.ca |
| François Lellouche, MD, PhD | Contact | 418-656-8711 | 3298 | francois.lellouche@criucpq.ulaval.ca |
| Name | Affiliation | Role |
|---|---|---|
| François Lellouche, MD, PhD | Fondation IUCPQ | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre de Recherche de l'IUCPQ | Recruiting | Québec | Quebec | G1V4G5 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32291309 | Derived | Delorme M, Bouchard PA, Simon M, Simard S, Lellouche F. Physiologic Effects of High-Flow Nasal Cannula in Healthy Subjects. Respir Care. 2020 Sep;65(9):1346-1354. doi: 10.4187/respcare.07306. Epub 2020 Apr 14. |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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|
| Conventional flow via nasal prongs | Device | Low flow of air delivered through conventional nasal prongs |
|
| Comfort of breathing | Subjective evaluation at the end of each period | 10 minutes |
| Blood gases | Arterial or capillary blood gases at the end of each period | 10 minutes |
| Dyspnea | Evaluation on a borg scale at the end of each period | 10 minutes |
| Respiratory Rate | Measured at the end of each period | 10 minutes |
| End-tidal carbon dioxide | Measured at the end of each period | 10 minutes |
| Heart rate | Measured at the end of each period | 10 minutes |
| Oxygen saturation | Measured at the end of each period | 10 minutes |