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Trial registered on ANZCTR
Registration number
ACTRN12622001278729
Ethics application status
Approved
Date submitted
20/09/2022
Date registered
29/09/2022
Date last updated
2/12/2022
Date data sharing statement initially provided
29/09/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Transcutaneous Oxygen and Nasal High Flow in healthy adults
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Scientific title
Transcutaneous oxygen and Nasal High flow: a prospective, interventional, crossover, randomised, feasibility study investigating the effect of nasal high flow oxygen delivery on transcutaneous oxygen partial pressure in healthy adults
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Secondary ID [1]
308005
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none
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Universal Trial Number (UTN)
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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:
Anaesthesia
327677
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Condition category
Condition code
Anaesthesiology
324761
324761
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0
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Other anaesthesiology
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Respiratory
324784
324784
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0
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Normal development and function of the respiratory system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
100% oxygen delivered at 70 L/min via nasal high flow until transcutaneous oxygen partial pressure (TcO2) plateau or 30 minutes maximum, whichever occurs first. This will be followed by a washout period until TcO2 returns to baseline or 1 hour maximum, whichever occurs first. Adherence will be monitored by direct supervision for the duration of the intervention by a member of the study team.
Participants will be in a resting state and instructed to breath normally for the duration of the study maintaining a rate of approximately 10-12 breaths per minute. Participants will be given the first flow rate for 30 minutes or until TcO2 reaches a plateau, whichever occurs first. A plateau is defined as when TcO2 increases by no more than 1 kPa over 5 minutes. Nasal high flow will then be stopped and TcO2 will be monitored until TcO2 returns to baseline (+/- 1kPa), whichever occurs first. Then the process will be repeated with the second flow rate. All interventions will be administered by a research doctor and the study will be conducted at an onsite clinic at Fisher & Paykel Healthcare.
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Intervention code [1]
324457
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Treatment: Devices
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Comparator / control treatment
100% oxygen delivered at 10 L/min via nasal high flow until transcutaneous oxygen partial pressure (TcO2) plateau or 30 minutes maximum, whichever occurs first. This will be followed by a washout period until TcO2 returns to baseline or 1 hour maximum, whichever occurs first. Adherence will be monitored by direct supervision for the duration of the intervention by a member of the study team. The first flow rate and second flow rate will have a washout period in between (1 hour maximum or until TcO2 returns to baseline, whichever occurs first).
Participants will be in a resting state and instructed to breath normally for the duration of the study maintaining a rate of approximately 10-12 breaths per minute. Participants will be given the first flow rate for 30 minutes or until TcO2 reaches a plateau, whichever occurs first. A plateau is defined as when TcO2 increases by no more than 1 kPa over 5 minutes. Nasal high flow will then be stopped and TcO2 will be monitored until TcO2 returns to baseline (+/- 1kPa), whichever occurs first. Then the process will be repeated with the second flow rate. All interventions will be administered by a research doctor and the study will be conducted at an onsite clinic at Fisher & Paykel Healthcare.
Both flow rates will be administered in a crossover fashion to determine intra-participant variability of TcO2 measurements in response to nasal high flow. The total duration of study intervention, which includes both flow rates and washout periods will be no more than 3 hours.
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Control group
Active
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Outcomes
Primary outcome [1]
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Absence or presence of a transcutaneous oxygen partial pressure (TcO2) plateau. A transcutaneous oxygen monitor will be used to continuously record in TcO2 measurements for the entire duration of the study.
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Assessment method [1]
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Timepoint [1]
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Assessed until TcO2 reaches a plateau for a maximum cut-off of 30 min.
TcO2 will be monitored continuously from the time of commencement of nasal high flow until TcO2 reaches a plateau or up to a maximum of 30 minutes of nasal high flow, whichever occurs first.
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Secondary outcome [1]
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Time to TcO2 plateau (if present) measured by using a transcutaneous oxygen monitor.
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Assessment method [1]
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Timepoint [1]
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Assessed when TcO2 reaches a plateau with a maximum cut-off of 30 min. TcO2 will be monitored continuously from commencement of nasal high flow until TcO2 reaches a plateau or up to a maximum of 30 minutes, whichever occurs first.
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Secondary outcome [2]
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Time fromTcO2 plateau (if present) to baseline TcO2 using a transcutaneous oxygen monitor.
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Assessment method [2]
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Timepoint [2]
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Assessed when TcO2 returns to baseline with a maximum cut-off of 1 hour. TcO2 will be monitored continuously once nasal high flow is stopped from TcO2 plateau until TcO2 returns to baseline or up to 1 hour after nasal high flow is stopped, whichever occurs first.
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Secondary outcome [3]
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Adverse events and serious adverse events determined by clinical assessment.
Some foreseeable adverse events are nasal/throat pain, atelectasis, skin irritation, nose/throat discomfort. Adverse events will be assessed by participant self-reported or symptom directed physical exam.
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Assessment method [3]
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Timepoint [3]
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Monitored from the commencement of study intervention until the end of the second washout period.
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Eligibility
Key inclusion criteria
1. Willing and able to provide written informed consent
2. 18 to 40 years of age, inclusive
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. Participants where continuous positive airway pressure and nasal high flow are contraindicated (e.g. nasal congestion, currently has or has history of epistaxis, pneumothorax, bullous lung disease, craniofacial trauma, airway foreign body).
2. Known active use of tobacco, vapes, or other inhaled substances.
3. BMI > 35 kg/m2
4. Known fragile skin and/or adhesive allergy
5. Other underlying medical condition that will be unfavourable for the administration of nasal high flow therapy or may impair compliance with study conduct.
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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 opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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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
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Statistical methods / analysis
Standard descriptive statistics including means, standard deviations, range, frequencies, and percentages will be used to describe the presenting participant demographic features.
The endpoint measure will be summarised as the geometric means of each treament and as geometric mean ratio (70L/min / 10 L/min) of TcO2 plateau.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
28/11/2022
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Actual
29/11/2022
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Date of last participant enrolment
Anticipated
8/12/2022
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Actual
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Date of last data collection
Anticipated
9/12/2022
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Actual
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Sample size
Target
6
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Accrual to date
2
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Final
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Recruitment outside Australia
Country [1]
25015
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Funding source category [1]
312268
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Commercial sector/Industry
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Name [1]
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Fisher & Paykel Healthcare
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Address [1]
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15 Maurice Paykel Place,
East Tamaki,
Auckland 2013
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Country [1]
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New Zealand
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Primary sponsor type
Commercial sector/Industry
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Name
Fisher & Paykel Healthcare
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Address
15 Maurice Paykel Place,
East Tamaki,
Auckland 2013
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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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Address [1]
313810
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Country [1]
313810
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311642
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Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
311642
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03/10/2022
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Approval date [1]
311642
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15/11/2022
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Ethics approval number [1]
311642
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Summary
Brief summary
Transcutaneous oxygen partial pressure (TcO2) is a non-invasive method to measure oxygen partial pressure in participants. TcO2 may also be a useful method to measure the effectiveness of oxygenation in humans, particularly of use in future clinical studies involving healthy volunteers assessing the performance of novel extensions to the NHF system. However, the reliability of TcO2 to measure the effectiveness of oxygenation via NHF has not been previously investigated. The study is a two arm, randomised controlled, crossover feasibility study to explore transcutaneous oxygen partial pressure (TcO2) as a potential measure for the effectiveness of oxygenation using NHF. Participants will be given NHF at the following flow rates with the standard mechanical flow meter: - Treatment A: 100% O2 at 10 L/min - Treatment B: 100% O2 at 70 L/min Participants will be randomised (1:1) to the sequence of treatment (A-B or B-A). Participants will be instructed to breath normally for the duration of the study, maintaining a respiratory rate of approximately 10-12 breaths per minute. Participants will be given the first flow rate for 30 minutes or until TcO2 reaches a plateau, whichever occurs first. A plateau is defined as when TcO2 increases no more than 1 kPa over 5 minute. Nasal high flow will then be stopped and TcO2 will be monitored for 1 hour or until TcO2 returns to baseline (+/- 1kPa), whichever occurs first. Then the process will be repeated with the second flow rate. We will include 6 participants randomised at a 1:1 ratio, 3 participants per crossover sequence. The feasibility endpoints for this study will be: ability to achieve TcO2 plateau, time to TcO2 plateau (if present), time from TcO2 plateau (if present) to baseline, and inter- and intra- participant variability of TcO2. Adverse events will also be collected. We are conducting this study to confirm whether these endpoints are obtainable and useful for a future non-inferiority study. Data from this study will also be used to calculate the sample size needed for the proposed future study.
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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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Prof Alan Merry
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Address
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Fisher & Paykel Healthcare
15 Maurice Paykel Place
East Tamaki
Auckland 2013
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Country
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New Zealand
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Phone
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+64 214932297
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Aya Cervantes
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Address
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Fisher & Paykel Healthcare
15 Maurice Paykel Place
East Tamaki
Auckland 2013
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Country
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New Zealand
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Phone
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+64 95740100
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Amanda Potts
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Address
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Fisher & Paykel Healthcare
15 Maurice Paykel Place
East Tamaki
Auckland 2013
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Country
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New Zealand
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Phone
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+64 95740100
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Fax
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Email
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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
This is an internal feasibility study to aid in product development. Individual participant data will not be shared publicly.
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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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