Airway Pressure During Humidified High Flow Nasal Cannula Therapy in Children
|Bronchiolitis Pneumonia Bronchial Asthma|
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Airway Pressure During Humidified High Flow Nasal Cannula Therapy in Children|
- Airway pressure measurement [ Time Frame: will be measured at start of HHFNC therapy and with titration of flow rate. ]oesophageal pressure will be measured as a surrogate of airway pressure using Nasogastric tube liquid filled technique.
- predictors of positive airway pressure delivery. [ Time Frame: will be measured simultaneously with airway pressure ]The secondary outcomes of this study are predictors that may influence the delivery of positive airway pressures during HHFNC, such as the delivered flow per weight of patient, disease severity, work of breathing and nasal cannula: nares diameter ratio.
|Study Start Date:||June 2015|
|Estimated Study Completion Date:||June 2016|
|Estimated Primary Completion Date:||June 2016 (Final data collection date for primary outcome measure)|
Background: Respiratory failure is one of the most common reasons for admission to the Pediatric Critical Care Unit (PCCU). 17% of children admitted to a PCCU require some form of invasive or non-invasive mechanical respiratory support. HHFNC therapy was first introduced in early 2000 and hence is a relatively new mode of respiratory support. One of the proposed mechanisms of action of HHFNC is by providing airway positive pressure hence considered as non-invasive mode of ventilation in pediatrics. However, the actual amount of positive airway pressure that HHFNC provides at increasing flow rates has not been well studied in children.
Objectives: The investigators' objectives are to measure the positive airway pressure delivered with increasing HHFNC flow rates in children, and to evaluate the variables that may influence the delivery of positive airway pressure during HHFNC.
Methods & Design: This is an observational cohort study which will be conducted at McMaster children`s hospital, pediatric critical care unit (PCCU). Children under 18 years of age, admitted to PCCU, who require respiratory support by HHFNC, as determined by the caring physician; and informed consent and or assent of substitute decision maker. Those children must have NG tube of size 10 French or smaller inserted at time of HHFNC application. Patients who are on intermittent NGT suction will be excluded. Airway pressure will be measured indirectly using esophageal pressure liquid filled method.
Data Analysis Baseline demographics will be summarized using counts (%) for categorical variables, and mean (standard deviation) or median and interquartile range (IQR) as appropriate for continuous variables. Estimates of the pressure will be reported as mean (95% confidence interval [CI]). Relationship of pressure to delivered flow will be analysed using analysis of variance. Regression methods will be used to determine if the following factors delivered flow per weight of patient, patient size, disease severity, work of breathing and nasal cannula: nares diameter ratio are associated with air pressure
Please refer to this study by its ClinicalTrials.gov identifier: NCT02387632
|Contact: Karen Choong, FRCP(C)||905-525-9140 ext email@example.com|
|Contact: Hamood Alshueili, MDfirstname.lastname@example.org|
|McMaster Children's Hospital||Recruiting|
|Hamilton, Ontario, Canada, L8N 3Z5|
|Contact: Karen Choong, MB, BCh, MSc 905-5212100 ext 75617 email@example.com|
|Principal Investigator: Hamood Al Shuieli, MD|
|Principal Investigator: Juliana Giraldo Salazar, MD|
|Principal Investigator:||Karen Choong, FRCP(C)||McMaster University|