This study is meant to compare the amount of oxygen required for hypoxemia relief between current standard of care (oxygen only) and oxygen with the addition of high flow air for Chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung Disease (ILD), and Pulmonary Hypertension (PH) patients during rest. Subjects will be titrated from 0 L/min until they maintain 95% SpO2 for each of the following delivery methods: 1. Pulses of pure oxygen (control) 2. Constant high flow air with pulses of pure oxygen 3. Out of phase pulses of high flow air and pure oxygen
Each participant will require (1) visit, which will last approximately 4-5 hours. At start of visit: 1. Vitals are taken (temperature, heart rate, SpO2, respiration rate, blood pressure, Borg dyspnea score, Mmrc score) while participant is seated and using their normal oxygen prescription. 2. Patient will remain seated during the following procedure with SpO2 and heart rate continuously being monitored. Pulsed Oxygen Control at Rest: 1. Participant's oxygen will be turned off for 10 minutes as a washout period. 2. Using the oxygen tank with the pulse regulator, the participant will be titrated to a pulse rate that maintains their SpO2 at an average of 95%. a. Increasing volumes of oxygen in 1 L(liter)/min increments every thirty seconds until an average of 95% SpO2 is maintained for 30 seconds. 3. Once the participant is titrated to the correct amount of oxygen, they will remain on the oxygen for an additional 3 minutes 4. Final oxygen flow rate, SpO2, Heart Rate, and Borg Dyspnea Score will be recorded in the last minute of the test. Mixed Continuous Air/Oxygen Efficacy at Rest: 5. Participant's oxygen will be turned off for 10 minutes as a washout period. 6. The participant will be delivered pulsed oxygen and high flow ambient air using the oxygen tank with the pulse regulator and Vapotherm setup, the participant will be titrated to a pulse rate that maintains their SpO2 at an average of 95%. 1. High flow ambient air will be set to 15 L/min 2. Increasing volumes of oxygen from in 1 L/min increments every thirty seconds until an average of 95% SpO2 is maintained for 30 seconds. 7. Once the participant is titrated the correct amount of oxygen, they will remain on the oxygen for an additional 3 minutes. 8. Final oxygen flow rate, SpO2, Heart Rate, and Borg Dyspnea Score will be recorded in the last minute of the test. 9. Steps 5-8 are then repeated two more times for pulsed oxygen plus continuous flow ambient air at flow rates of 20 and 25 L/min. Mixed Pulsed Air/Oxygen Efficacy at Rest: 10. Participant's oxygen will be turned off for 10 minutes as a washout period 11. The participant will be delivered the out-of-phase pulsed oxygen and high flow ambient air using the oxygen tank with the pulse regulator and Vapotherm setup, the participant will be titrated to a pulse rate that maintains their SpO2 at an average of 95% 1. High flow ambient air will be set to 15 L/min 2. Increasing volumes of oxygen from in 1L/min increments every thirty seconds until an average of 95% SpO2 is maintained for 30 seconds. 12. Once the participant is titrated the correct amount of oxygen, they will remain on the oxygen for an additional 3 minutes 13. Final oxygen flow rate, SpO2, Heart Rate, and Borg Dyspnea Score will be recorded in the last minute of the test. 14. Steps 10-13 are then repeated two more times for out-of phase pulsed oxygen plus pulsed high flow ambient air at flow rates of 20 and 25 L/min.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
11
They will receive high-flow air and oxygen via a dual lumen nasal cannula at rest. Participants will be administered the high-flow air and then titrated with oxygen from 0 L/min until they reach and maintain a SpO2 level of 95% for 30 seconds. They will then remain on this setting for 3 additional minutes with continuous monitoring of SpO2 levels.
They will receive oxygen via a dual lumen nasal cannula at rest. Participants will be titrated with oxygen from 0 L/min until they reach and maintain a SpO2 level of 95% for 30 seconds. They will then remain on this setting for 3 additional minutes with continuous monitoring of SpO2 levels.
The Johns Hopkins Hospital
Baltimore, Maryland, United States
Johns Hopkins Hospital Bayview Asthma and Allergy Center
Baltimore, Maryland, United States
Effectiveness of partial replacement of concentrated oxygen by high flow ambient air for Long Term Oxygen Therapy
This will be assessed using the difference between the oxygen delivery systems (pure oxygen and mixed high-flow air with oxygen) in the L/min flow of oxygen required for a participant to reach steady state at greater than or equal to 95% pulse oxygenation.
Time frame: up to 20 minutes
Dyspnea relief achieved with of partial replacement of concentrated oxygen by high flow ambient air for Long Term Oxygen Therapy
This will be assessed using the difference in relative dyspnea score evaluated with the Borg Dyspnea scale at the end of each delivery method. The Borg scale ranges from 0-10. Min: 0 (No dyspnea), Max: 10 (Very,Very Severe dyspnea).
Time frame: Approximately 15 minutes
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