CClinicalTrials.gg
CompletedNCT03279458Updated Jul 5, 2018Results posted

Non-invasive Tidal Volume Monitoring Using the Linshom Respiratory Monitoring Device

An interventional study of Linshom Respiratory Monitoring Device in Pulmonary Ventilation and Capnography, sponsored by University of Mississippi Medical Center. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-07-05.

Sponsored by University of Mississippi Medical Center · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

Many post-operative complications arise from patients who breathe inadequately. Inadequate respiration, whether the result of surgery or the anesthesia, causes a decrease in blood oxygen saturation and an increase in carbon dioxide partial pressure. Both of these surrogate measurements of respiration may pose a challenge to measure. Some administer exogenous oxygen to all patients as they leave the operating room in order to maintain the blood oxygen saturation. This renders the oximeter a less sensitive metric of depressed respiration. In the face of decreased respiration, the carbon dioxide levels continue to increase slowly and often go undetected unless blood gases are measured. Indeed carbon dioxide blood levels are the only metric to detect inadequate ventilation using this surrogate index.

Monitoring ventilation is a serious challenge outside of critical care settings. In fact, there are no monitors available that can measure tidal volume or relative tidal volume outside of these settings.

Linshom is a novel instrument that tracks relative respiration by measuring the excursions of the temperature swings between inspiration and expiration and normalizing them to the patient's breathing. This monitor may be the first non-invasive monitor to measure relative tidal volume in non-critical care settings.

The purpose of this study is to determine whether a non-invasive, temperature-based respiratory instrument can track tidal volume (Vt) in patients.

The investigators hypothesize that the Linshom device can accurately and consistently track tidal volume as measured by closed loop mechanical ventilator.

Read the detailed description

Forty volunteers will be enrolled in this open label, prospective study to determine the correlation between the tidal volumes measured with the Linshom detector and those measured with the mechanical ventilator. after Institutional Review Board (IRB) approval and written informed consent from the volunteers.

The Linshom detector, which is comprised of two rapid responding medical-grade thermistors in close proximity to the mouth/nose (sensor) and a thermistor remote to the airway, will be mounted in the continuous positive airway pressure (CPAP) face mask to measure the temperature during breathing. The CPAP will be connected to a Servo-I ventilator (Maquet) with a circuit and disposable filter. The volunteers will be instructed to breathe normal through the CPAP mask on room air. The excursions of the thermistor tracings (from valley to peak) will be recorded by the Linshom device and displayed continuously on a laptop monitor in a waveform. The tidal volume will also be measured by the ventilator and the data downloaded in a Compact Flash card. The temperature profiles from the sensors and the relative tidal volume will be correlated with the tidal volumes measured by the ventilator.

02

Conditions studied

  • Pulmonary Ventilation
  • Capnography

Keywords

  • Capnography
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • healthy

Exclusion criteria

Exclusion Criteria:

  • pregnant
  • suffer from claustrophobia
  • had recent respiratory illness
  • had recent gastrointestinal illness
  • unable to provide informed consent
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    Linshom Respiratory Monitoring Device

    Volunteers will breathe through a continuous positive airway pressure (CPAP) face mask fitted with the Linshom device. The volunteers will be instructed to breathe normal through the CPAP mask on room air. The excursions of the thermistor tracings (from valley to peak) will be recorded by the Linshom device and displayed continuously on a laptop monitor in a waveform.

    Device: Linshom Respiratory Monitoring Device

  • Active comparator
    Ventilator

    Volunteers will breathe through a continuous positive airway pressure (CPAP) face mask fitted with the Linshom device. The volunteers will be instructed to breathe normal through the CPAP mask on room air.The tidal volume will also be measured by the ventilator and the data downloaded in a Compact Flash card.

    Device: Linshom Respiratory Monitoring Device

Interventions

  • DeviceLinshom Respiratory Monitoring Device

    Volunteers will breathe through a continuous positive airway pressure (CPAP) face mask fitted wth the Linshom device. The volunteers will be instructed to breathe normal through the CPAP mask on room air. The excursions of the thermistor tracings (from valley to peak) will be recorded by the Linshom device and displayed continuously on a laptop monitor in a waveform. The tidal volume will also be measured by the ventilator and the data downloaded in a Compact Flash card.

05

What researchers measure

Primary outcomes

  1. Tidal Volume of Each Breath Was Measured Using the Same Breathing Mask CPAP Apparatus Combined With Respiratory Monitoring Device Allowing for Simultaneous Recording.

    Tidal volume measured by CPAP mask with Lishom respiratory monitoring device. Tidal volume determined from the ventilator will be compared to tidal volume measured by Linshom (calculated indirectly by temperature changes by computer algorithm)

    Time frame: 5 minutes

06

Results

Posted Jul 5, 2018

Participant flow

Participant flow — Overall Study
MilestoneLinshom Respiratory Monitoring Device
Started40
Completed40
Not completed0

Outcome measures

PrimaryTidal Volume of Each Breath Was Measured Using the Same Breathing Mask CPAP Apparatus Combined With Respiratory Monitoring Device Allowing for Simultaneous Recording.

Tidal volume measured by CPAP mask with Lishom respiratory monitoring device. Tidal volume determined from the ventilator will be compared to tidal volume measured by Linshom (calculated indirectly by temperature changes by computer algorithm)

Time frame:
5 minutes
Reported as:
Least squares mean · ml
Tidal Volume of Each Breath Was Measured Using the Same Breathing Mask CPAP Apparatus Combined With Respiratory Monitoring Device Allowing for Simultaneous Recording.
mlLinshomMaquet Ventilator
Tidal Volume of Each Breath Was Measured Using the Same Breathing Mask CPAP Apparatus Combined With Respiratory Monitoring Device Allowing for Simultaneous Recording.0.94 (0.88 to 0.97)0.94 (0.88 to 0.97)
Statistical analysis
  • Linshom vs Maquet Ventilator · Regression, Linear · p = <0.05 · Correlation coefficient (r): 0.94 · 95% CI 0.88 to 0.97

Adverse events

Collected over Adverse event data was collected for approximately 30 minutes, including the time while the patient was using the mask and the time immediately after completing the study.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Linshom0/40 (0%)0/40 (0%)0/40 (0%)
Maquet Ventilator0/40 (0%)0/40 (0%)0/40 (0%)

Baseline characteristics

Age, Customized
Age, Customized(Participants)Linshom
>= 18 years40
Sex: Female, Male
Sex: Female, Male(Participants)Linshom
Female—
Male—
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Linshom
Region of Enrollment
Region of Enrollment(participants)Linshom
United States40
Number of participants
Number of participants(Participants)Linshom
Count of participants40
07

Study locations

1 site
  • University of Mississippi Medical Center
    Jackson, Mississippi 39216, United States
08

References and documents

Publications

  • Manifold CA, Davids N, Villers LC, Wampler DA. Capnography for the nonintubated patient in the emergency setting. J Emerg Med. 2013 Oct;45(4):626-32. doi: 10.1016/j.jemermed.2013.05.012. Epub 2013 Jul 18. PubMed 23871325 ↗
  • Brouillette RT, Morrow AS, Weese-Mayer DE, Hunt CE. Comparison of respiratory inductive plethysmography and thoracic impedance for apnea monitoring. J Pediatr. 1987 Sep;111(3):377-83. doi: 10.1016/s0022-3476(87)80457-2. PubMed 3625404 ↗
  • Ramsay MA, Usman M, Lagow E, Mendoza M, Untalan E, De Vol E. The accuracy, precision and reliability of measuring ventilatory rate and detecting ventilatory pause by rainbow acoustic monitoring and capnometry. Anesth Analg. 2013 Jul;117(1):69-75. doi: 10.1213/ANE.0b013e318290c798. Epub 2013 Apr 30. PubMed 23632055 ↗
  • Keidan I, Gravenstein D, Berkenstadt H, Ziv A, Shavit I, Sidi A. Supplemental oxygen compromises the use of pulse oximetry for detection of apnea and hypoventilation during sedation in simulated pediatric patients. Pediatrics. 2008 Aug;122(2):293-8. doi: 10.1542/peds.2007-2385. PubMed 18676546 ↗
  • Williamson JA, Webb RK, Cockings J, Morgan C. The Australian Incident Monitoring Study. The capnograph: applications and limitations--an analysis of 2000 incident reports. Anaesth Intensive Care. 1993 Oct;21(5):551-7. doi: 10.1177/0310057X9302100510. PubMed 8273874 ↗
  • Nassi N, Piumelli R, Lombardi E, Landini L, Donzelli G, de Martino M. Comparison between pulse oximetry and transthoracic impedance alarm traces during home monitoring. Arch Dis Child. 2008 Feb;93(2):126-32. doi: 10.1136/adc.2007.118513. Epub 2007 Sep 24. PubMed 17893118 ↗
  • Kasuya Y, Akca O, Sessler DI, Ozaki M, Komatsu R. Accuracy of postoperative end-tidal Pco2 measurements with mainstream and sidestream capnography in non-obese patients and in obese patients with and without obstructive sleep apnea. Anesthesiology. 2009 Sep;111(3):609-15. doi: 10.1097/ALN.0b013e3181b060b6. PubMed 19672177 ↗
  • Lerman J, Feldman D, Feldman R, Moser J, Feldman L, Sathyamoorthy M, Deitch K, Feldman U. Linshom respiratory monitoring device: a novel temperature-based respiratory monitor. Can J Anaesth. 2016 Oct;63(10):1154-1160. doi: 10.1007/s12630-016-0694-y. Epub 2016 Jul 13. PubMed 27412466 ↗

Study documents

  • Protocol and statistical analysis plan · Jun 21, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — No plan to share IPD

09

Registry details

Key details

Study ID
NCT03279458
Lead sponsor
University of Mississippi Medical Center
Responsible party
Madhankumar Sathyamoorthy (Associate Professor, University of Mississippi Medical Center) — Principal investigator
First posted
Sep 12, 2017
Start date
Sep 8, 2017
Primary completion
Sep 8, 2017
Completion
Sep 8, 2017
Results posted
Jul 5, 2018
Last update
Jul 5, 2018

Study contacts

Madhankumar Sathyamoorthy, MBBS, MS
principal investigator · Children's of Mississippi/University of Mississippi Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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