Evaluation of Safety and Efficacy of Short time TNI Treatment in Patients with COPD and hypercapnia. Acute testing of oxygen demand using TNI vs. standard oxygen application in stable COPD patients with hypercapnia.
TNI, the nasal insufflation of a high flow of warm, humidified air, is an extremely comfortable and uncomplicated alternative to numerous other approaches in non-invasive ventilation (NIV). Up to now, NIV therapy could only be applied by masks with the associated complications as patients could not tolerate high airflow delivered by a thin nasal cannula without humidification and warming, thus causing concomitant negative effects. The new therapy TNI shows a high rate of acceptance by children, too. At present, there are two different types of devices available for nasal insufflation in clinics: TNI 20s, an air humidifier for clinical compressed air, and the TNI20 oxy, an air humidifier for clinical compressed air, which can be combined with oxygen. TNI 20 oxy The system, which is unique throughout the world, is optimized for the application of flows of up to 20L/min and fulfils the minimum requirements of the "American Society of Testing and Materials" for a high flow air humidifier in the non-invasive application of 10 mg H2O/L (equivalent to about 60% rel. humidity at an ambient temperature of 22°C) for the air humidity. The warming of the air flow by 5-15°C can be adjusted relative to the ambient temperature. Condensation is prevented in the nasal applicator by heating the tube as far as the nostrils. The device automatically controls humidity and temperature depending on the prevailing ambient conditions. The TNI®20s can be attached to the hospital infrastructure by means of a standard pressure regulator. In another ongoing study (STIT-1) TNI 20 oxy was evaluated for its safety in COPD patients without hypercapnia. In a first interim analysis which included 14 patients high flow oxygen delivery was safe.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
30
Nasal insufflation at a constant high flow of 15 L/min with oxygen addition starting at 0.5 L/min
Nasal insufflation of oxygen starting at at flow of 0.5 L/min.
Christian Kähler
Innsbruck, Austria
RECRUITINGPneumologie, Medizinische Klinik und Poliklinik I, University of Dresden
Dresden, Germany
NOT_YET_RECRUITINGKlinik für Innere Medizin V, Universitätsklinikum Homburg, University of Homburg/Saar
Homburg, Germany
PaO2
Change in the partial oxygen pressure in the arterial blood (blood gas analysis) at a defined oxygen flow rate (L/min)
Time frame: 60 min
O2%
Change in the oxygen saturation in the arterial blood (blood gas analysis) at a defined oxygen flow rate (L/min)
Time frame: 60 min
PaCO2
Change in the PaCO2 in the arterial blood (blood gas analysis) at a defined oxygen flow rate (L/min)
Time frame: 60 min
AaDO2
Change in the AaDO2 in the peripheral blood at a defined oxygen flow rate (L/min)
Time frame: 60 min
RV and TLC
No increase in the residual volume (RV) and the total lung capacity (TLC) \> 15% of the mean actual value at visits 1 and 2 (measurement 60 + 10 minutes after oxygen insufflation with a TNI system).
Time frame: 60 min
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Klinik und Poliklinik für Pneumologie, Inselspital Berne, University of Berne
Bern, Switzerland
RECRUITING