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Airway DiseaseNCT03666403

Airway Pressure and Lumen Changes During NIV With Flexible Bronchoscopy

A study testing NIV rate: 0/min, NIV rate: 10-20/min and NIV rate: 5-10/min in people with Airway Disease, run by Taipei Veterans General Hospital, Taiwan at 2 sites in Taiwan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Introduction: The non-invasive ventilation (NIV) of continuous nasopharyngeal O2 with intermittent close/open nose and abdomen compression (PO2-NC-AC) can provide effective oxygenation, ventilation and circulation. It needs no any instruments, therefore no limits upper and lower airways. Read more about this study

Who is it for?
Ages 6 months to 3 yearsHealthy volunteers can take part
Conditions the study is for
Airway Disease
What is being tested?
NIV rate: 0/min, NIV rate: 10-20/min and NIV rate: 5-10/min
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
2 sitesTaiwan
Study dates
1 Jan 2018to 13 Jul 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 months to 3 years
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • age no more than 3 years old
  • a natural airway lumen without prior plasty;
  • difficult weaning from current respiratory support and therefore
  • scheduled for elective FB for highly suspected airway problems.

Who cannot join

  • uncontrollable cardiopulmonary failure
  • body weight less than 2.0 kg
  • bleeding tendency.
  • fixed/ too narrowed airways where the FB (OD 3.8 mm) could not pass through

Trial locations and contacts

2 sites in 1 country.

Taiwan2 sites
  • Taipei-Veterans General Hospital

    Taipei, 11217

  • Teipei Veterans General Hospital

    Taipei, 112

Other trials in Taiwan

About this study

Official title: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan

Introduction: The non-invasive ventilation (NIV) of continuous nasopharyngeal O2 with intermittent close/open nose and abdomen compression (PO2-NC-AC) can provide effective oxygenation, ventilation and circulation. It needs no any instruments, therefore no limits upper and lower airways. Both animal, clinical studies and experiences have already demonstrated its safety and efficacy in high risky and severe asphyxiated conditions. Making pressure (PEEP and PIP) changes is an essential for creating assist PPV. In children, airway lumen images are dynamic and positively correlate to the intraluminal pressure levels, such as the lumen open or close pressure. Closely measuring and monitoring these airway pressures and associated lumen image changes can benefit for making accurate diagnosis and enhance clinical management.

Purpose: Prospective study to evaluate the dynamic changes of upper and lower airway: 1) PEEP and PIP levels; and 2) the associated changes of lumen image by using FB with this NIV technique in small children with airway anomaly.

Read more

Study candidates: Children who: a) need FB examination or management for clinical reasons; b) age ≤5 year-old; and c) with airway anomaly; will enroll to this study. Expect enrolls a total of 30 children in one-year period.

Methods: As usually doing the FB with cardiopulmonary monitor and this NIV support in pediatric intensive care unit settings. A small catheter connects the inner cannel of FB and links to a pressure monitor. During course of FB, records the intra-airway lumen pressures (PEEP, PIP) and takes associated images. Total record (study) time in each enrolled case about 5 minutes. This study will not prolong the FB time. Finally, analysis these associated data.

Prediction: This study (30 enrolled cases) can smoothly complete in one-year period.

Benefits: This modality of FB with NIV may: 1) more safely doing; 2) get scientific data to prove it's efficacy; and 3) benefit for both clinical diagnosis and management; in children with airway anomaly.

Read the detailed description
  • As usually doing the FB with cardiopulmonary monitor and this NIV support in pediatric intensive care unit settings.
  • A small catheter connects the inner cannel of FB and links to a pressure monitor.
  • During course of FB, records the intra-lumen pressures (PEEP, PIP) and takes associated images at assigned 6 airway locations, if possible.
  • These 6 locations are: Oropharynx, Supra-glottis, Mid-trachea, Supra-carina Right main bronchus, and Left main bronchus.
  • Thus, a complete FB would involve 6 pairs of measurements in each child.
  • Both results of PIP levels and images were then stored in a computer for later analysis.
  • Total record (study) time in each enrolled case about 5 minutes. This study will not prolong the FB time. Finally, analysis these associated data.
  • For objective evaluation of the lumen changes, three captured images were grouped by 6 locations in each child. These lumen dimensions were independently judged on a five-point Likert scale (1 to 5: very collapse, collapse, average, expansion, very expansion) within one week by four qualified pediatric bronchoscopists who were blinded to the source of these images. The final scores were averaged and analyzed.
  • Statistical Analysis: The categorical variables were described as percentages and compared with the Chi-square or Fisher's exact test as appropriate. A two-tailed p <0.05 was considered to be statistically significant.
Conditions
Airway Disease
Being tested
NIV rate: 0/min, NIV rate: 10-20/min, NIV rate: 5-10/min
Keywords
airway pressure, bronchomalacia, tracheomalacia, positive pressure ventilation, airway expansion, noninvasive ventilation
Medical subject headings
Bronchomalacia, Tracheomalacia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • NIV rate: 0/minProcedure or surgery

    A basic PhO2 flow was routinely provided. A small pharyngeal catheter with warmed, humidified and fixed pure oxygen flow was inserted via one nostril to ensured catheter tip positioning in the oropharynx. The NIV was performed in the following steps. Firmly closed the mouth, then intermittently applied a) assisted inspiration by nose-closure accompanied with cricoid depression; and b) assisted expiration by the release of above nose and cricoid maneuver but with simultaneous abdomen-compression. The above assisted ventilation cycle was maintained at a rate of 0-20 cycles per minute. The scopist executed both the FB and the nose-closure and release, whereas an assistant delivered the abdomen compression.

  • NIV rate: 10-20/minProcedure or surgery

    A basic PhO2 flow was routinely provided. A small pharyngeal catheter with warmed, humidified and fixed pure oxygen flow was inserted via one nostril to ensured catheter tip positioning in the oropharynx. The NIV was performed in the following steps. Firmly closed the mouth, then intermittently applied a) assisted inspiration by nose-closure accompanied with cricoid depression; and b) assisted expiration by the release of above nose and cricoid maneuver but with simultaneous abdomen-compression. The above assisted ventilation cycle was maintained at a rate of 0-20 cycles per minute. The scopist executed both the FB and the nose-closure and release, whereas an assistant delivered the abdomen compression.

  • NIV rate: 5-10/minProcedure or surgery

    A basic PhO2 flow was routinely provided. A small pharyngeal catheter with warmed, humidified and fixed pure oxygen flow was inserted via one nostril to ensured catheter tip positioning in the oropharynx. The NIV was performed in the following steps. Firmly closed the mouth, then intermittently applied a) assisted inspiration by nose-closure accompanied with cricoid depression; and b) assisted expiration by the release of above nose and cricoid maneuver but with simultaneous abdomen-compression. The above assisted ventilation cycle was maintained at a rate of 0-20 cycles per minute. The scopist executed both the FB and the nose-closure and release, whereas an assistant delivered the abdomen compression.

Study groups in NCT03666403
Study groupRoleWhat they receive
PatientsExperimentalThis prospective one-year study enrolled consecutive 30 children of ≤3 years-old with suspected major airway diseases and therefore scheduled for diagnostic FB. During FB, PIP measurements and associated lumen images were obtained at six airway locations using three studied NIV modes, including 1) NIV rate: 0/min, 2) NIV rate: 10-20/min, 3) NIV rate: 5-10/min.
Receives: Procedure: NIV rate: 0/min; Procedure: NIV rate: 10-20/min; Procedure: NIV rate: 5-10/min

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Intra- airway Positive inspiration pressure (PIP)

    When doing these 3 modes of NIV, measure the intra-airway PIP at 6 assigned different locations.

    When doing this NIV, measure the PIP at 6 different airway locations

    Measured: intra-procedure, when the tips of FB locate in the assigned airway location

Secondary outcomes (1)
  1. Intra-airway lumen expansion

    When doing these 3 modes of NIV, take and measure the lumen expansion at 6 different airway locations.

    Measured: intra-procedure, when the tips of FB locate in the assigned airway location

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Sep 2018
  2. Study start1 Jan 2018
  3. Primary completion30 Jun 2018
  4. Study completion13 Jul 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Model description
Upon the pharyngeal oxygen setting, this classic NIV operation was performed as per our protocol illustrated in the following steps. Firmly closed the mouth, then intermittently applied: a) assisted inspiration by nose-closure accompanied with cricoid depression; and b) assisted expiration by the release of above nose and cricoid maneuver, and simultaneous doing abdomen-compression. The above assisted ventilation cycle was performed at a rate of 0-20 cycles per minute. The bronchoscopist optionally executed both the FB and the nose- closure and release, whereas an assistant delivered the abdomen-compression.
Masking
None (open label)
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03666403
Sponsor's protocol ID
2017-07-009B
Status last verified
Sep 2018
First submitted
28 Aug 2018
Last updated
11 Sep 2018
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: When these data are reasonable for this study.

Publications

  • Lin YT, Lee YS, Jeng MJ, Chen WY, Tsao PC, Chan IC, Soong WJ. Flexible bronchoscopic findings and the relationship to repeated extubation failure in critical children. J Chin Med Assoc. 2018 Sep;81(9):804-810. doi: 10.1016/j.jcma.2018.03.008. Epub 2018 May 31.

    PubMed 29861210
  • Soong WJ, Tsao PC, Lee YS, Yang CF. Flexible endoscopy for pediatric tracheobronchial metallic stent placement, maintenance and long-term outcomes. PLoS One. 2018 Feb 8;13(2):e0192557. doi: 10.1371/journal.pone.0192557. eCollection 2018.

    PubMed 29420596
  • Soong WJ, Tsao PC, Lee YS, Yang CF. Therapeutic flexible airway endoscopy of small children in a tertiary referral center-11 years' experience. PLoS One. 2017 Aug 17;12(8):e0183078. doi: 10.1371/journal.pone.0183078. eCollection 2017.

    PubMed 28817604
  • Soong WJ, Tsao PC, Lee YS, Yang CF. Retrieval of tracheobronchial foreign bodies by short flexible endoscopy in children. Int J Pediatr Otorhinolaryngol. 2017 Apr;95:109-113. doi: 10.1016/j.ijporl.2017.01.033. Epub 2017 Feb 16.

    PubMed 28576517
  • Soong WJ, Tsao PC, Lee YS, Yang CF, Liao J, Jeng MJ. Retrieving difficult aspirated pen caps by balloon catheter with short working-length flexible endoscopy and noninvasive ventilation support in intensive care unit. Int J Pediatr Otorhinolaryngol. 2015 Sep;79(9):1484-9. doi: 10.1016/j.ijporl.2015.06.033. Epub 2015 Jul 3.

    PubMed 26188901
  • Yang CF, Niu DM, Jeng MJ, Lee YS, Taso PC, Soong WJ. Late-onset Pompe disease with left-sided bronchomalacia. Respir Care. 2015 Feb;60(2):e26-9. doi: 10.4187/respcare.03419. Epub 2014 Oct 14.

    PubMed 25316892
  • Soong WJ, Jeng MJ, Lee YS, Tsao PC, Harloff M, Matthew Soong YH. A novel technique of non-invasive ventilation: Pharyngeal oxygen with nose-closure and abdominal-compression--Aid for pediatric flexible bronchoscopy. Pediatr Pulmonol. 2015 Jun;50(6):568-75. doi: 10.1002/ppul.23028. Epub 2014 Mar 10.

    PubMed 24616304
  • Soong WJ, Jeng MJ, Lee YS, Tsao PC, Soong YH. Nasopharyngeal oxygen with intermittent nose-close and abdomen-compression: a novel resuscitation technique in a piglet model. Pediatr Pulmonol. 2013 Mar;48(3):288-94. doi: 10.1002/ppul.22592. Epub 2012 May 2.

    PubMed 22553182
  • Soong WJ, Lee YS, Tsao PC, Yang CF, Jeng MJ. Comparison of oxygenation among different supplemental oxygen methods during flexible bronchoscopy in infants. J Chin Med Assoc. 2011 Dec;74(12):556-60. doi: 10.1016/j.jcma.2011.09.016. Epub 2011 Oct 28.

    PubMed 22196471
  • Soong WJ, Jeng MJ, Lee YS, Tsao PC, Yang CF, Soong YH. Pediatric obstructive fibrinous tracheal pseudomembrane--characteristics and management with flexible bronchoscopy. Int J Pediatr Otorhinolaryngol. 2011 Aug;75(8):1005-9. doi: 10.1016/j.ijporl.2011.04.020. Epub 2011 Jun 2.

    PubMed 21640393
  • Peng YY, Soong WJ, Lee YS, Tsao PC, Yang CF, Jeng MJ. Flexible bronchoscopy as a valuable diagnostic and therapeutic tool in pediatric intensive care patients: a report on 5 years of experience. Pediatr Pulmonol. 2011 Oct;46(10):1031-7. doi: 10.1002/ppul.21464. Epub 2011 May 27.

    PubMed 21626712
  • Soong WJ, Shiao AS, Jeng MJ, Lee YS, Tsao PC, Yang CF, Soong YH. Comparison between rigid and flexible laser supraglottoplasty in the treatment of severe laryngomalacia in infants. Int J Pediatr Otorhinolaryngol. 2011 Jun;75(6):824-9. doi: 10.1016/j.ijporl.2011.03.016. Epub 2011 Apr 21.

    PubMed 21513991
  • Soong WJ, Lee YS, Soong YH, Tsao PC, Yang CF, Jeng MJ, Peng YY. Tracheal foreign body after laser supraglottoplasty: a hidden but risky complication of an aluminum foil tape-wrapped endotracheal tube. Int J Pediatr Otorhinolaryngol. 2010 Dec;74(12):1432-4. doi: 10.1016/j.ijporl.2010.08.019. Epub 2010 Oct 8.

    PubMed 20934755
  • Chen WT, Soong WJ, Lee YS, Jeng MJ, Chang HL, Hwang B. The safety of aerodigestive tract flexible endoscopy as an outpatient procedure in young children. J Chin Med Assoc. 2008 Mar;71(3):128-34. doi: 10.1016/S1726-4901(08)70004-2.

    PubMed 18364264
  • Soong WJ. Endoscopic intubation with aid of mechanical ventilation via a dedicated nasopharyngeal airway. J Chin Med Assoc. 2007 Sep;70(9):400-2. doi: 10.1016/S1726-4901(08)70028-5.

    PubMed 17908656

Questions about this trial

What is this clinical trial studying?

A study testing NIV rate: 0/min, NIV rate: 10-20/min and NIV rate: 5-10/min in people with Airway Disease, run by Taipei Veterans General Hospital, Taiwan at 2 sites in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Sep 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Intra- airway Positive inspiration pressure (PIP) (time frame: intra-procedure, when the tips of FB locate in the assigned airway location). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03666403, which also lists 29 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Sep 2018.

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