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COPD ExacerbationNCT03696563

FreeO2 PreHospital - Automated Oxygen Titration vs Manual Titration According to the BLS-PCS

A study testing Automated oxygen administration - FreeO2 and Standard administration of oxygen flow in people with COPD Exacerbation and Trauma, run by François Lellouche.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Evaluation of automated oxygen titration in comparison with manual adjustment oxygen in the out-of-hospital setting by paramedics. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
COPD Exacerbation, Trauma
What is being tested?
Automated oxygen administration - FreeO2 and Standard administration of oxygen flow
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
No sites listed yet
Study dates
Sep 2021to Jun 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • COPD patient:
  • Known or suspected acute exacerbation of COPD. Acute exacerbation is defined by worsening of the respiratory condition for less than 2 weeks. Suspected COPD is defined by patients of at least 30 years old with respiratory symptoms with a past or current smoking history of at least 10 pack years, or
  • Able to measure SpO2 via pulse oximetry
  • Trauma patient:
  • Trauma: patients who sustain any trauma (minor or major), II) Able to measure SpO2 via pulse oximetry
  • Pregnancy
Show all 9Show fewer
  • Age <18 years
  • Prehospital Invasive or non-invasive mechanical ventilation
  • Meeting high concentration oxygen administration injury or condition (as per BLS-PCS Oxygen Therapy Standard (Version 3.0), s(2)a-f).

Who cannot join

None listed.

Trial locations and contacts

No sites are listed yet.

About this study

Official title: Automated Administration of Oxygen Using the FreeO2 Device in Ambulances for COPD and Trauma Patients: A Feasibility Study

Evaluation of automated oxygen titration in comparison with manual adjustment oxygen in the out-of-hospital setting by paramedics.

Read the detailed description

It is a single center study in Ottawa, Ontario Canada.

This will be a single centered prehospital multi-period cluster crossover feasibility trial, enrolling patients in Ottawa, Ontario, who are treated by paramedics from the Ottawa Paramedic Service, who have been trained in the use of the automated oxygen delivery device. We will be using the FreeO2 device. Patients requiring oxygen therapy during prehospital transportation will be enrolled. No randomization will occur within this single centered feasibility study

Patients requiring oxygen therapy during the prehospital transportation will be enrolled and will be included as soon as they are placed into the ambulance, until handover and transfer of care at receiving hospital.

In both groups, SpO2 will be collected continuously every second with FreeO2 monitoring, in addition to the collection of vital signs carried out by the staff according to the standards.

Being tested
Automated oxygen administration - FreeO2, Standard administration of oxygen flow
Keywords
prehospital, oxygen therapy, automation, trauma, COPD
Medical subject headings
Wounds and Injuries, Pulmonary Disease, Chronic Obstructive

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Automated oxygen administration - FreeO2Device

    The adjustment of the oxygen flow will be made by the FreeO2 system, an automated titration of oxygen flow every second to reach the SpO2 target. The SpO2 target will be set at 90% in COPD patients and 94% in trauma patients.

  • Standard administration of oxygen flowOther

    The flow of oxygen will be administered according to the usual protocol during the transport and until transfer to the emergency departement.

Study groups in NCT03696563
Study groupRoleWhat they receive
Control groupActive comparatorIn this group, the - usual care based upon BLS-PCS with manual titration of oxygen. In this group the SpO2 was recorded any time with FreeO2 device - recording mode.
Receives: Other: Standard administration of oxygen flow
FreeO2 groupExperimentalThe adjustment of the oxygen flow will be made by the FreeO2 system, an automated titration to reach the SpO2 target set by paramedic.
Receives: Device: Automated oxygen administration - FreeO2

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Feasibility of the study design - REB approval

    Time to REB approval for single site time to REB approval for single site define by below 3 months (90 days) from REB submission, time to readiness to initiate the clinical trial after REB approval - below 3 months (90 days) from REB approval, evaluation of data collection tool - 100% of data captured in >90% case at hospital discharge (until day 28), Survey responses from Paramedics - At the end of the transportation day

    Measured: Date of REB submission to date of REB approval, target: until 3 months (90 days) from REB submission

  2. Feasibility of the study design - initiate the clinical trial

    Time to readiness to initiate the clinical trial

    Measured: Target until 3 months (90 days) from REB approval

  3. Feasibility of the study design - Evaluation of data collection tool

    target: 100% of data captured in >90% cases

    Measured: through study completion, an average of 1 year

  4. Feasibility of the study design - study protocol compliance

    Target of 80% of compliance for protocol intervention/control group

    Measured: through study completion,an average of 1 year

  5. Feasibility of the study design - Paramedics survey

    A survey will be complete by Paramedics at the end of day of transportation (day 1); the target response rate is 75% of case.

    Measured: through study completion, an average of 1 year

Secondary outcomes (11)
  1. Oxygenation - Total Time in the target zone SpO2

    Percentage of time spent in the target zone SpO2

    • 90±2% in the COPD population (in the range of 88 to 92%)
    • 94±2% in the trauma population (in the range of 92 to 96%)

    Measured: Day 1 - During prehospital transportation (from entry in the ambulance until exit of the ambulance)

  2. Oxygenation - Total time with hyperoxia

    Percentage of time spent in hyperoxia (SpO2 > 94% in COPD patients and SpO2 >98% in trauma patients)

    Measured: Day 1 - During prehospital transportation (from entry in the ambulance until exit of the ambulance)

  3. Oxygenation - Total time with hypoxemia

    Percentage of time spent in the target zone SpO2

    • % of time with hypoxemia (SpO2<86% in COPD patients and SpO2 <90% in trauma patients)

    Measured: Day 1 - During prehospital transportation (from entry in the ambulance until exit of the ambulance)

  4. The oxygentherapy complication- PaCO2

    -Evaluation of level of PaCO2 on the first ABG at ED or ICU admission (when available)

    Measured: Day 1- On The first ABG or capillary blood gases after hospital admission

  5. The oxygentherapy complication - respiratory acidosis

    -Evaluation of the rate of respiratory acidosis (pH<7.35 and PaCO2>45mmHg) after hospital admission

    Measured: Day 1- On The first ABG or capillary blood gases after hospital admission

  6. The rate of patients without oxygen at the end of the transportation

    Rate of patient weaned of oxygen at the end of the transportation

    Measured: Day 1 - At the end of the transportation (at the exit from the ambulance)

  7. Outcome data - NIV

    The rate of NIV use during lenght of stay in hospital

    Measured: through study completion, an average of 1 year

  8. Outcome data - ICU admission

    The rate of ICU admission during lenght of stay in hospital

    Measured: through study completion, an average of 1 year

  9. Outcome data - Death

    The rate of death during lenght of stay in hospital

    Measured: During hospital stay - hospital admission through study completion or until death if occured, up to 8 weeks

  10. Outcome data

    Duration of the hospital length of stay

    Measured: Length of hospital stay measured in calendar days, hospital admission through study completion, up to 8 weeks

  11. The oxygen consumption during the pre-hospital transport

    Mean O2 flow rate (total O2 consumption) during transportation

    Measured: Day 1 - During prehospital transportation (from entry in the ambulance until exit of the ambulance),

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Oct 2018
  2. Study startSep 2021 (estimated)
  3. Primary completionDec 2021 (estimated)
  4. Study completionJun 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Model description
This will be a single centered prehospital multi-period cluster crossover feasibility trial
Masking
None (open label)
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03696563
Sponsor's protocol ID
20180570-01H
Status last verified
Nov 2020
First submitted
18 Dec 2017
Last updated
12 Nov 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is not plan to share individual participant data. All data if shared with be de-identified. Data will be stored on a secure server with access only by study personal.

Publications

  • Johannigman JA, Branson R, Lecroy D, Beck G. Autonomous control of inspired oxygen concentration during mechanical ventilation of the critically injured trauma patient. J Trauma. 2009 Feb;66(2):386-92. doi: 10.1097/TA.0b013e318197a4bb.

    PubMed 19204511
  • Johannigman JA, Muskat P, Barnes S, Davis K Jr, Beck G, Branson RD. Autonomous control of oxygenation. J Trauma. 2008 Apr;64(4 Suppl):S295-301. doi: 10.1097/TA.0b013e31816bce54. No abstract available.

    PubMed 18385582
  • Higuchi S, Fukushi G, Baba T, Sasaki D, Yoshida Y. New method of testing for carbohydrate absorption in man. Xylose and sucrose absorption; effects of sucrase inhibition. Dig Dis Sci. 1986 Apr;31(4):369-75. doi: 10.1007/BF01311671.

    PubMed 3956333
  • O'Driscoll BR, Howard LS, Davison AG; British Thoracic Society. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008 Oct;63 Suppl 6:vi1-68. doi: 10.1136/thx.2008.102947. No abstract available.

    PubMed 18838559
  • Branson RD, Johannigman JA. Pre-hospital oxygen therapy. Respir Care. 2013 Jan;58(1):86-97. doi: 10.4187/respcare.02251.

    PubMed 23271821
  • Hale KE, Gavin C, O'Driscoll BR. Audit of oxygen use in emergency ambulances and in a hospital emergency department. Emerg Med J. 2008 Nov;25(11):773-6. doi: 10.1136/emj.2008.059287.

    PubMed 18955625
  • Aubier M, Murciano D, Fournier M, Milic-Emili J, Pariente R, Derenne JP. Central respiratory drive in acute respiratory failure of patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1980 Aug;122(2):191-9. doi: 10.1164/arrd.1980.122.2.191.

    PubMed 6774639
  • Aubier M, Murciano D, Milic-Emili J, Touaty E, Daghfous J, Pariente R, Derenne JP. Effects of the administration of O2 on ventilation and blood gases in patients with chronic obstructive pulmonary disease during acute respiratory failure. Am Rev Respir Dis. 1980 Nov;122(5):747-54. doi: 10.1164/arrd.1980.122.5.747.

    PubMed 6778278
  • Dunn WF, Nelson SB, Hubmayr RD. Oxygen-induced hypercarbia in obstructive pulmonary disease. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):526-30. doi: 10.1164/ajrccm/144.3_Pt_1.526.

    PubMed 1909846
  • Sassoon CS, Hassell KT, Mahutte CK. Hyperoxic-induced hypercapnia in stable chronic obstructive pulmonary disease. Am Rev Respir Dis. 1987 Apr;135(4):907-11. doi: 10.1164/arrd.1987.135.4.907.

    PubMed 3565937
  • DAVIES CE, MACKINNON J. Neurological effects of oxygen in chronic cor pulmonale. Lancet. 1949 Nov 12;2(6585):883-5, illust. doi: 10.1016/s0140-6736(49)91459-2. No abstract available.

    PubMed 15393115
  • Wiener AS, Cioffi AF. A group B analogue of subgroup A 3. Am J Clin Pathol. 1972 Dec;58(6):693-7. doi: 10.1093/ajcp/58.6.693. No abstract available.

    PubMed 4629769
  • Murphy R, Mackway-Jones K, Sammy I, Driscoll P, Gray A, O'Driscoll R, O'Reilly J, Niven R, Bentley A, Brear G, Kishen R. Emergency oxygen therapy for the breathless patient. Guidelines prepared by North West Oxygen Group. Emerg Med J. 2001 Nov;18(6):421-3. doi: 10.1136/emj.18.6.421. No abstract available.

    PubMed 11696486
  • Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS; GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001 Apr;163(5):1256-76. doi: 10.1164/ajrccm.163.5.2101039. No abstract available.

    PubMed 11316667
  • Kettel LJ, Diener CF, Morse JO, Stein HF, Burrows B. Treatment of acute respiratory acidosis in chronic obstructive lung disease. JAMA. 1971 Sep 13;217(11):1503-8. No abstract available.

    PubMed 5109747

Questions about this trial

What is this clinical trial studying?

A study testing Automated oxygen administration - FreeO2 and Standard administration of oxygen flow in people with COPD Exacerbation and Trauma, run by François Lellouche.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 12 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Michael Austin (613-737-7228, maustin@toh.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility of the study design - REB approval (time frame: Date of REB submission to date of REB approval, target: until 3 months (90 days) from REB submission). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03696563, which also lists 37 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Nov 2020.

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