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| Name | Class |
|---|---|
| Spaulding Clinical Research LLC | OTHER |
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This study will combine Duffin's rebreathing procedure with additional study procedures, such as quantitative pupillometry, that are planned for subsequent clinical studies in order to confirm feasibility and gather reproducibility data using the procedure. The reproducibility of Duffin rebreathing has been assessed previously by Mahamed and Duffin (2001) performing hyperoxic and hypoxic rebreathing procedures measured once daily for 14 consecutive days and then by Jensen et al. (2010) performing 4 pairs of hyperoxic and hypoxic rebreathing procedures in 1 day followed by 1 pair on 4 additional days separated by weeks to more than a month.
The present study is an unblinded reproducibility assessment to assess variability of the ventilatory response to Duffin's rebreathing procedure. Subjects will report to the study site for screening between Days -28 to -2 and then will return to the site on Day -1 for baseline assessments and check-in. After check-in (Day -1), subjects will remain in study site for PD assessments on Day 1 and check out on Day 2.
Paired rebreathing procedures (i.e., at two different isoxic end tidal PO2 [partial pressure oxygen] levels) will be performed on Day 1 at 0, 2, 4, and 6 hours. An additional pair of rebreathing procedures will be performed on Day 2 before checkout (approximately 24 hours). Subjects will not be administered any drugs in this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lead-In | Experimental | Multiple rebreathing procedures using methodology developed by Duffin (referred to as Duffin's rebreathing procedure) will be conducted under hyperoxic and hypoxic conditions over the course of a day to confirm feasibility and gather reproducibility data using the procedure. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rebreathing procedure | Other | Paired Duffin's rebreathing procedures performed two different isoxic end tidal PO2 levels (i.e., hyperoxic and hypoxic conditions) will be performed on Day 1 at 0, 2, 4, 6, and 24 hours. |
| Measure | Description | Time Frame |
|---|---|---|
| Baseline Minute Ventilation | Minute ventilation during the rebreathing assessment when end tidal PCO2 (partial pressure carbon dioxide) is less than the ventilatory recruitment threshold (represents non-chemoreflex drives to breathe; 'flat' portion of minute ventilation versus end tidal PCO2 relationship). Data was analyzed using linear-mixed effects regression of baseline minute ventilation with random effects for between subject, between day, and between occasion variability. Reported value is the mean for the treatment group across all individuals, days, and times. | 0, 2, 4, 6 and 24 hours |
| Ventilatory Recruitment Threshold | The end tidal PCO2 point above which minute ventilation starts to increase linearly with further increases in end tidal PCO2. Data was analyzed using linear-mixed effects regression of ventilatory recruitment threshold with random effects for between subject, between day, and between occasion variability. Reported value is the mean for the treatment group across all individuals, days, and times. | 0, 2, 4, 6 and 24 hours |
| Slope of the PCO2-ventilatory Response Curve | Slope of the minute ventilation versus end tidal PCO2 curve that reflects the increase in minute ventilation relative to the increase in end tidal PCO2. Data was analyzed using linear-mixed effects regression of Slope of the PCO2-ventilatory response curve with random effects for between subject, between day, and between occasion variability. Reported value is the mean for the treatment group across all individuals, days, and times. | 0, 2, 4, 6 and 24 hours |
| Extrapolated Ventilatory Recruitment Threshold | Intersection of the slope of the PCO2-ventilation response curve with the X axis. Data was analyzed using linear-mixed effects regression of extrapolated ventilatory recruitment threshold with random effects for between subject, between day, and between occasion variability. Reported value is the mean for the treatment group across all individuals, days, and times. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jan Matousek, D.O. | Spaulding Clinical Research LLC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Spaulding Clinical Research | West Bend | Wisconsin | 53095 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21514404 | Background | Duffin J. Measuring the respiratory chemoreflexes in humans. Respir Physiol Neurobiol. 2011 Jul 31;177(2):71-9. doi: 10.1016/j.resp.2011.04.009. Epub 2011 Apr 14. | |
| 11454975 | Background | Mahamed S, Duffin J. Repeated hypoxic exposures change respiratory chemoreflex control in humans. J Physiol. 2001 Jul 15;534(Pt. 2):595-603. doi: 10.1111/j.1469-7793.2001.00595.x. |
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Enrollment was halted after 7 participants as sufficient experience with the experimental technique was obtained to move on to subsequent studies.
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| ID | Title | Description |
|---|---|---|
| FG000 | Lead-In | Multiple rebreathing procedures using methodology developed by Duffin (referred to as Duffin's rebreathing procedure) will be conducted under hyperoxic and hypoxic conditions over the course of a day to confirm feasibility and gather reproducibility data using the procedure. Rebreathing procedure: Paired Duffin's rebreathing procedures performed two different isoxic end tidal PO2 levels (i.e., hyperoxic and hypoxic conditions) will be performed on Day 1 at 0, 2, 4, 6, and 24 hours. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Lead-In | Multiple rebreathing procedures using methodology developed by Duffin (referred to as Duffin's rebreathing procedure) will be conducted under hyperoxic and hypoxic conditions over the course of a day to confirm feasibility and gather reproducibility data using the procedure. Rebreathing procedure: Paired Duffin's rebreathing procedures performed two different isoxic end tidal PO2 levels (i.e., hyperoxic and hypoxic conditions) will be performed on Day 1 at 0, 2, 4, 6, and 24 hours. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Baseline Minute Ventilation | Minute ventilation during the rebreathing assessment when end tidal PCO2 (partial pressure carbon dioxide) is less than the ventilatory recruitment threshold (represents non-chemoreflex drives to breathe; 'flat' portion of minute ventilation versus end tidal PCO2 relationship). Data was analyzed using linear-mixed effects regression of baseline minute ventilation with random effects for between subject, between day, and between occasion variability. Reported value is the mean for the treatment group across all individuals, days, and times. | All participants who successfully completed one rebreathing assessment. | Posted | Mean | Standard Deviation | L/min | 0, 2, 4, 6 and 24 hours |
|
2 days
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Hyperoxic Rebreathing | Multiple rebreathing procedures using methodology developed by Duffin (referred to as Duffin's rebreathing procedure) will be conducted under hyperoxic conditions (maintained isoxic 150 mmHg) at 0, 2, 4,6, and 24 hours. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| David Strauss, MD, PhD | U.S. Food and Drug Administration | 301-796-6323 | David.Strauss@fda.hhs.gov |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 9, 2022 | Jun 19, 2023 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D053120 | Respiratory Aspiration |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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This study is an unblinded reproducibility assessment to assess variability of the ventilatory response to Duffin's rebreathing procedure. The lead-in reproducibility assessment will have up to 10 healthy volunteer participants.
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| 0, 2, 4, 6 and 24 hours |
| 20035904 | Background | Jensen D, Mask G, Tschakovsky ME. Variability of the ventilatory response to Duffin's modified hyperoxic and hypoxic rebreathing procedure in healthy awake humans. Respir Physiol Neurobiol. 2010 Feb 28;170(2):185-97. doi: 10.1016/j.resp.2009.12.007. Epub 2009 Dec 24. |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG001 | Hypoxic Rebreathing | Multiple rebreathing procedures using methodology developed by Duffin (referred to as Duffin's rebreathing procedure) were conducted under hypoxic conditions (maintained isoxic 50 mmHg) at 0, 2, 4, 6, and 24 hours. |
|
|
| Primary | Ventilatory Recruitment Threshold | The end tidal PCO2 point above which minute ventilation starts to increase linearly with further increases in end tidal PCO2. Data was analyzed using linear-mixed effects regression of ventilatory recruitment threshold with random effects for between subject, between day, and between occasion variability. Reported value is the mean for the treatment group across all individuals, days, and times. | All participants who successfully completed one rebreathing assessment. | Posted | Mean | Standard Deviation | mmHg | 0, 2, 4, 6 and 24 hours |
|
|
|
| Primary | Slope of the PCO2-ventilatory Response Curve | Slope of the minute ventilation versus end tidal PCO2 curve that reflects the increase in minute ventilation relative to the increase in end tidal PCO2. Data was analyzed using linear-mixed effects regression of Slope of the PCO2-ventilatory response curve with random effects for between subject, between day, and between occasion variability. Reported value is the mean for the treatment group across all individuals, days, and times. | All participants who successfully completed one rebreathing assessment. | Posted | Mean | Standard Deviation | L/min/mmHg | 0, 2, 4, 6 and 24 hours |
|
|
|
| Primary | Extrapolated Ventilatory Recruitment Threshold | Intersection of the slope of the PCO2-ventilation response curve with the X axis. Data was analyzed using linear-mixed effects regression of extrapolated ventilatory recruitment threshold with random effects for between subject, between day, and between occasion variability. Reported value is the mean for the treatment group across all individuals, days, and times. | All participants who successfully completed one rebreathing assessment. | Posted | Mean | Standard Deviation | mmHg | 0, 2, 4, 6 and 24 hours |
|
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|
| 0 |
| 7 |
| 0 |
| 7 |
| 0 |
| 7 |
| EG001 | Hypoxic Rebreathing | Multiple rebreathing procedures using methodology developed by Duffin (referred to as Duffin's rebreathing procedure) were conducted under hypoxic conditions (maintained isoxic 50 mmHg) at 0, 2, 4, 6, and 24 hours. | 0 | 7 | 0 | 7 | 0 | 7 |
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