The purpose of this study is to compare clinical outcomes in patients with acute COPD treated with a vibrating mesh nebuliser (VMN) versus a current standard jet nebuliser (JN), in the Emergency Department (ED). Participants will be those who meet the inclusion criteria and have a primary diagnosis of COPD, and consent to take part in the study. Operators will be clinical staff including doctors and nurses who will be trained in the use of the nebulisers. Delivery of current treatment standards utilising a VMN compared to a JN will improve symptom scores in patients attending ED with COPD exacerbations.
This study is a prospective, single-centre, open, randomised study to improve management of acute COPD exacerbation within the Emergency Department. Adults with severe COPD are randomised into 2 groups: vibrating mesh nebuliser or standard jet nebuliser treatment. Salbutamol (5mg) and Ipratropium (0.5mg) will be administered via Aerogen Ultra via valved mask or a standard jet nebuliser via open face mask/. Two further doses of salbutamol to be delivered.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
150
Jet Nebuliser
Aerogen Device
Emergency Department Queen Elizabeth University Hospital
Glasgow, Scotland, United Kingdom
RECRUITINGBORG Score
Change in Reported Dyspnoea. Modified BORG dyspnoea scale. 0 (best) min 10 max (worse)
Time frame: 30 minutes post treatment
Oscillometry
Change of Oscillometry data
Time frame: 30 minutes post treatment
Escalation of Care
Requirement for NIV (non invasive ventilation) / Intubation / further nebulisation
Time frame: During Emergency Department Admission (typically < 4 hours)
Blood Gas
Change in blood gases post treatment
Time frame: 30 minutes post treatment
Completion of Treatment
Time to complete initial nebulisation therapy in ED
Time frame: During Emergency Department Admission (typically < 4 hours)
Staff Satisfaction
Reported ED staff satisfaction from main care giver post treatment. Likert 5 point scale. (0 highly dissatisfied 5 highly satisfied)
Time frame: During Emergency Department Admission (typically < 4 hours)
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