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Trial registered on ANZCTR
Registration number
ACTRN12616000363482
Ethics application status
Approved
Date submitted
15/03/2016
Date registered
21/03/2016
Date last updated
14/05/2019
Date data sharing statement initially provided
14/05/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Humidified high flow air for children and young people with Cystic Fibrosis (CF): A pilot study
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Scientific title
Pilot Study of Humidified High Flow Air via Nasal Cannulae (HHF) During Sleep for Children and Young People with Cystic Fibrosis (CF)
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Secondary ID [1]
288762
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nil known
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Universal Trial Number (UTN)
U1111-1174-6606
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cystic Fibrosis
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Condition category
Condition code
Respiratory
298170
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The primary intervention for this study is humidified high flow (HHF) air via nasal canulae during sleep. The air will be delivered at 100% relative humidity. No additional oxygen will be used. This is a crossover study and participants will receive in randomised order i) five nights of usual care and ii) five nights of HHF therapy in addition to usual care. HHF will be delivered at an individualized rate of between 20 and 45 L/min depending on participant weight. The study will be conducted in the participant's home. Adherence will not be monitored. Treatment acceptability will be assessed by questionnaire.
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Intervention code [1]
294201
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Treatment: Devices
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Comparator / control treatment
Comparator is usual treatment (no placebo). This will be determined by the usual treating phsyician and consists of twice daily chest physiotherapy with oral vitamin and calorific supplemenation. Participants may be on oral azithromycin. Some participants will continue on their usual nebulised pulmozyme, hypertonic saline or nebulised antibiotics.
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Control group
Active
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Outcomes
Primary outcome [1]
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Respiratory rate in sleep measured during limited channel polysomnography in the home.
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Assessment method [1]
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Timepoint [1]
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Overnight during sleep on the 5th night of each treatment period.
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Secondary outcome [1]
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Oxygen saturation in sleep measured during limited channel polysomnography in the home.
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Assessment method [1]
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Timepoint [1]
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Overnight during sleep on the 5th night of each treatment period.
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Secondary outcome [2]
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Heart rate in sleep measured during limited channel polysomnography in the home.
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Assessment method [2]
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Timepoint [2]
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Overnight during sleep on the 5th night of each treatment period.
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Secondary outcome [3]
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Daytime sleepiness (ESS questionnaire)
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Assessment method [3]
321811
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Timepoint [3]
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In the morning after the 5th night of therapy of each treatment period
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Secondary outcome [4]
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Treatment satisfaction (unvalidated questionnaire )
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Assessment method [4]
321812
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Timepoint [4]
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In the morning after the 5th night of therapy of each treatment period
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Secondary outcome [5]
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Sleep quality (Leeds Sleep Evaluation Questionnaire)
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Assessment method [5]
321970
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Timepoint [5]
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Each morning after sleep for 5 mornings during each treatment period
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Secondary outcome [6]
321971
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Breathlessness and cough (both from Cystic Fibrosis Breathlessness Assessment Visual Analog Scale) - composite secondary outcome
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Assessment method [6]
321971
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Timepoint [6]
321971
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Each morning after sleep for 5 mornings during each treatment period
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Secondary outcome [7]
321972
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Apnoea and hypopnoea scored during limited channel home polysomnography - composite secondary outcome
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Assessment method [7]
321972
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Timepoint [7]
321972
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Overnight during sleep on 5th night of each treatment period
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Eligibility
Key inclusion criteria
- Children and young people aged 6 years to 25 years with a confirmed diagnosis of cystic fibrosis
- Mild or moderate disease
- The participant is in a stable period of well-being.
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Minimum age
6
Years
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Maximum age
25
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- FEV1 <= 30% predicted for height, age and gender
- Participant already requires respiratory support in sleep with oxygen, HHF, CPAP or VPAP.
- Participant under the care of the Lung Transplant team
- Exacerbation or symptoms of an exacerbation within the last 4 weeks
- Participant has additional complex diagnosis such as immune deficiency, cardiac disease or malignancy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed envelope
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Paired t-test with repeated measures analysis for outcomes measured on a daily basis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
4/04/2016
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Actual
1/12/2016
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Date of last participant enrolment
Anticipated
19/11/2018
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Actual
30/07/2018
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Date of last data collection
Anticipated
24/12/2018
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Actual
17/08/2018
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Sample size
Target
15
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Accrual to date
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Final
16
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Recruitment outside Australia
Country [1]
7707
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New Zealand
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State/province [1]
7707
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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A+ Trust
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Address [1]
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Auckland District Health Board Charitable Trust
Private Bag 92024
Auckland 1023
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Country [1]
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New Zealand
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Primary sponsor type
Hospital
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Name
Auckland District Health Board (contact Dr David McNamara)
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Address
Private Bag 92024
Auckland 1023
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
291919
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern B Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health Freyberg Building 20 Aitken Street PO Box 5013 Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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06/01/2016
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Approval date [1]
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04/03/2016
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Ethics approval number [1]
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16/NTB/1
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Summary
Brief summary
Cystic fibrosis (CF) is a common genetic disorder affecting approximately 1 in 3000 people in New Zealand. CF results in thickened airway mucus which causes infection, inflammation and loss of lung function with gradual onset of respiratory failure. Individuals with CF have poor growth and failure to thrive occuring through malabsorption of fat and fat-soluble nutrients, but also through increased energy expenditure with increased work of breathing. Unlike healthy controls, persons with CF have an increased respiratory rate and work of breathing during sleep. Reducing this may have long term benefits in improving respiratory health, weight gain and overall quality of life. Humidified high flow air via nasal prongs (HHF) is a novel but increasingly utilized treatment to decrease work of breathing. It is currently used in the hospital setting, but is a relatively easy treatment to deliver in the home. HHF delivers flows up to 70 L/min via nasal prongs and if delivered through sleep may benefit persons with CF by : i) Reducing the work of breathing through reduced upper airway resistance and dead space ii) Improving oxygenation iii) Increasing hydration of airway secretionsimproving airway secretion clearance As well as short term benefits – these could result in more substantial long term benefits with improved weight gain and reduced respiratory infections – both directly associated with disease prognosis. The Starship Respiratory Department is the national centre for children with CF, and the national centre for sleep and home respiratory support providing outreach to other hospitals around New Zealand. In this - initial randomised controlled cross-over study, we will determine the effect of HHF compared to a usual night of ‘unsupported’ sleep in 15 young persons with CF on respiratory rate, work of breathing, and other physiological parameters as well as measuring sleep quality. We will also determine the acceptability of having this support in the home. If effective and acceptable this will inform the development of a larger multi-centre study measuring the effect of HHF on longerterm outcomes such as weight gain, respiratory infections , ability to exercise, quality of life, and general well-being. HHF is potentially an effective new treatment to be used in the home to prevent disease progression and improve longevity.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr David McNamara
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Address
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Starship Children's Hospital
Private Bag 92024
Grafton
Auckland, 1023
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Country
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New Zealand
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Phone
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+6421982483
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Fax
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Email
64386
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[email protected]
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Contact person for public queries
Name
64387
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David McNamara
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Address
64387
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Starship Children's Hospital
Private Bag 92024
Grafton
Auckland, 1023
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Country
64387
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New Zealand
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Phone
64387
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+6421982483
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Fax
64387
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Email
64387
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[email protected]
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Contact person for scientific queries
Name
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David McNamara
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Address
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Starship Children's Hospital
Private Bag 92024
Grafton
Auckland, 1023
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Country
64388
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New Zealand
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Phone
64388
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+6421982483
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Fax
64388
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Email
64388
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Privacy requirement of ethical approval
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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