The changes in expiratory flow limitation during increasing levels of external PEEP in COPD patients can be followed with the deltaXrs-8 using FOT.To evaluate whether the deltaXrs is good outcome parameter to determine the external PEEP level needed…
ID
Source
Brief title
Condition
- Bronchial disorders (excl neoplasms)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
deltaXrs (cmH20.s/L) at 8 Hz (mid inspiratory minus mid expiratory Xrs) at
increasing levels of PEEP
Secondary outcome
Negative swing inintrapleural pressure at the beginning of the inspiration
measured with an esophageal balloon
Variation in bloodpressure during inspiration and exspiration
spirometry: IC (L)
Xrs-8, 12,16,20,24 (cmH20.s/L) Rrs-8,12,16,20,24 (cmH20.s/L)
Background summary
Expiratory flow limitation (EFL) is a major determinant of dyspnea and
hyperinflation in COPD. Dynamic hyperinflation caused by EFL increases the
work of breathing, impairs the function of inspiratory muscles and has adverse
effects on hemodynamics. At the end of expiration a positive end-expiratory
pressures, intrinsic PEEP, is present. Application of external positive
end-expiratory pressure (PEEP) during CPAP (continuous positive airway
pressure) may counterbalance the inspiratory threshold load caused by intrinsic
PEEP and thereby reducing the work of breathing and the adverse effects on
haemodynamics. In a previous study we showed that it is possible to detect EFL
with the within-breath forced oscillation technique using maximum overlap
discrete Fourier transform and bivariate least squares analysis. The deltaXrs
(mid inspiratory minus mid expiratory Xrs) at 8 and 12 Hz is a specific and
sensitive tool to detect COPD patients with EFL at rest during normal quiet
breathing.
Study objective
The changes in expiratory flow limitation during increasing levels of external
PEEP in COPD patients can be followed with the deltaXrs-8 using FOT.
To evaluate whether the deltaXrs is good outcome parameter to determine the
external PEEP level needed to counterbalance the intrinsic PEEP without causing
further hyperinflation.
Study design
Interventional research.
Intervention
CPAP at different levels of presure (0, 4, 6, 8,10 cmH2O)
Study burden and risks
Participating in this study is low risk. All pulmonary function tests are
executed conform the ERS standards. Expected benefit can be improved
diagnostics of their pulmonary disease and new insights in the treatment of EFL
in COPD patients in the future.
Wilhelminalaan 12
1815JD
NL
Wilhelminalaan 12
1815JD
NL
Listed location countries
Age
Inclusion criteria
Presenting to the outpatient clinic
Age 50-80 years
Diagnosed with COPD according to the standard criteria
Gold Stage II or IV COPD
Current or ex-smokers (at least 10 PY)
Stable disease (No current exacerbation or exacerbation during the 4 weeks previous to the inclusion)
Exclusion criteria
History of exacerbation of COPD in the preceding month
Upper airway obstruction
Allergic Asthma
OSAS (obstructive sleep apnea syndrome)
Extreme obesity (BMI>30)
Pulmonary disease other than COPD
Clinically manifest cardiac disease (for example clinically relevant congestive heart failure, unstable angina pectoris)
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL24161.094.08 |