High concentration oxygen therapy in pediatric asthma exacerbation

ISRCTN ISRCTN48562837
DOI https://doi.org/10.1186/ISRCTN48562837
Secondary identifying numbers 2015-4431
Submission date
15/06/2016
Registration date
17/06/2016
Last edited
17/05/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Asthma Is a common long term health condition caused by inflammation of the bronchi, small tubes that carry air in and out of the lungs. The airways can become narrow if the sufferer comes into something that “triggers” their asthma – for example animal fur, pollen, viral infection and exercise. This can cause symptoms such as coughing, wheezing, tightness of the chest and feeling breathless. Occasionally, asthma symptoms can gradually or suddenly get much worse. This is called an asthma attack. Severe attacks may require hospital treatment and, in extreme cases, can even lead to death. This study is looking at the use of oxygen in children who are having an asthma attack. The researchers are investigating whether the amount of oxygen used affects the carbon dioxide in children suffering from an asthma attack and whether it makes their asthma worse and/or results in their hospitalization.

Who can participate?
Children 2-18 years of age suffering from a moderate to severe asthma attack and are coming to the emergency room (ED)

What does the study involve?
Participants are randomly allocated to one of two groups. Those in group 1 receive 100% oxygen as part of their treatment. Those in group 2 receive titrated oxygen to keep that oxygen level between 92 to 95% while they are receiving their nebulization treatments.

What are the possible benefits and risks of participating?
There are no direct benefits from participating in this study. There are no risks from participating in this study as the oxygen levels are always kept in the normal range in both groups.

Where is the study run from?
The Children's Hospital at Montefiore, Bronx, New York (USA)

When is study starting and how long is it expected to run for?
December 2013 to May 2016

Who is funding the study?
Pediatric Critical Care Division, Children's Hospital at Montefiore (USA)

Who is the main contact?
Dr Bhavi Patel

Contact information

Dr Bhavi Patel
Public

The Children's Hospital at Montefiore
3415 Bainbridge Avenue
Bronx
New York
10467
United States of America

Study information

Study designSingle-center randomized prospective double-blind clinical trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet No participant information sheet available
Scientific titleRandomized clinical trial of high concentration oxygen therapy versus titrated oxygen therapy in pediatric asthma exacerbation
Study objectivesHigh concentration oxygen leads to rise in transcutaneous carbon dioxide in acute exacerbation of asthma in the pediatric population.
Ethics approval(s)Albert Einstein College of Medicine Institutional Board Review, 22/04/2015, ref: 2015-4431
Health condition(s) or problem(s) studiedPediatric asthma exacerbation
InterventionChildren 2 to 18 years with previously diagnosed asthma with moderate to severe asthma exacerbation (asthma score > 5) were randomized to high concentration oxygen therapy (100% oxygen via face mask at >4L/min) or titrated oxygen therapy (titrated up from 21% via a blender continuously) to maintain saturations between 92 to 95% while receiving their nebulized treatments.

Randomization was based on computer randomization sequence program generated by the biostatistician.
Intervention typeOther
Primary outcome measureRise in transcutaneous carbon dioxide, measured via a transcutaneous carbon dioxide monitor at 0, 20, 40, 60 minutes and then every 30 minutes till disposition decision was reached by the ED physician
Secondary outcome measures1. Change of > 4 mmHg PtCO2 and > 38 mmHg PtCO2 measured via a transcutaneous Co2 monitor at 0, 20, 40, 60 minutes and then every 30 minutes till disposition decision was reached by the ED physician
2. Change in asthma score, measured via a validated respiratory score tool used by the hospital as part of the asthma treatment pathway at 0, 20, 40, 60 minutes and then every 30 minutes till disposition decision was reached by the ED physician
3. Admission rates
Overall study start date01/12/2013
Completion date18/05/2016

Eligibility

Participant type(s)Patient
Age groupChild
Lower age limit2 Years
Upper age limit18 Years
SexBoth
Target number of participants104
Key inclusion criteriaPatients between 2 to 18 years with previous medical diagnosis of asthma presenting with moderate to severe asthma exacerbation with asthma score > 5
Key exclusion criteria1. Disorders with hypercapnic respiratory failure such as neuromuscular disease, chest wall restriction, or obesity hypoventilation
2. Unconscious patient
3. Pregnancy
4. Receiving sedatives/depressants
5. History of congenital heart disease
6. Disease of cardiac, renal, or hepatic systems
7. History of smoking
Date of first enrolment01/08/2015
Date of final enrolment18/05/2016

Locations

Countries of recruitment

  • United States of America

Study participating centre

The Children's Hospital at Montefiore
3415 Bainbridge Avenue
Bronx
New York
10467
United States of America

Sponsor information

Pediatric Critical Care Department
Hospital/treatment centre

3415 Bainbridge Avenue
Bronx
New York
10467
United States of America

Funders

Funder type

Hospital/treatment centre

Department of Pediatric Critical Care at the Children's Hospital at Montefiore (CHAM)

No information available

Results and Publications

Intention to publish date31/12/2016
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planHope to get manuscript published in the next 6 months.
IPD sharing plan

Editorial Notes

17/05/2017: Internal review.