Active not recruitingNAINTERVENTIONAL

Low-Flow vs. High-Flow Nasal Cannula for Hypoxemic Immunocompromised Patients During Diagnostic Bronchoscopy

This study is for patients with weakened immune systems who have a lung infection and need a test called a bronchoscopy. A bronchoscopy involves looking inside the lungs with a small camera to find out what's causing the infection. We usually give a small amount of oxygen through a tube in the nose during this test. Sometimes, a patient's oxygen levels can drop, making it necessary to increase oxygen or even use a breathing machine. This study is comparing the usual low-flow oxygen with a different device called 'Optiflow'. Optiflow gives more oxygen through the nose and is comfortable. Researchers want to see if using Optiflow can prevent oxygen levels from dropping during the bronchoscopy.

At a glance

Status

Active not recruiting

Phase

Sponsor

Mount Sinai Hospital, Canada

Enrolment target

Start

10 Jan 2018

Estimated completion

31 Dec 2025

Immunocompromised Hematologic Malignancy Post Hematopoietic Stem Cell Transplant Hypoxia Pulmonary Infiltrates

What is this study about?

When people have a weakened immune system, often due to conditions like cancer or after they've had a special treatment called a stem cell transplant, they can sometimes get lung infections like pneumonia. To figure out exactly what kind of infection it is and how best to treat it, doctors might suggest a test called a bronchoscopy.

During a bronchoscopy, a doctor uses a very thin tube with a tiny camera on the end to look inside your lungs and collect small samples of fluid. This helps them identify the germs causing the infection. While this is happening, you normally receive a little oxygen through a soft tube placed in your nose. For some patients, especially those with severe pneumonia, their oxygen levels in the blood might go down during the procedure. If this happens, the test might need to be paused or even stopped early. Sometimes, more oxygen is needed, or in rare cases, a breathing machine might be used temporarily.

This study is looking at a different way to give oxygen during this test. It's called 'Optiflow' and it delivers a higher amount of oxygen through a comfortable nasal tube. Optiflow is already used in many hospitals to help patients with low oxygen levels. Researchers are trying to find out if using Optiflow during a bronchoscopy can help prevent your blood oxygen from dropping, making the procedure safer and smoother for patients with weakened immune systems.

Key takeaways

The study compares two ways of giving oxygen during a lung test called a bronchoscopy.
It's for patients with weakened immune systems who have a lung infection.
'Optiflow' is a device that provides more oxygen through comfortable nasal tubes.
The aim is to see if Optiflow can stop oxygen levels from dropping during the test.
Participation involves receiving one of two oxygen methods during your scheduled bronchoscopy.
You can stop taking part at any time without affecting your medical care.

Who may be eligible?

This study is looking for adults aged 18 or over. You might be able to join if you are scheduled for a bronchoscopy and have a weakened immune system. This could be because you have a type of blood cancer (hematologic malignancy) or you've recently had a stem cell transplant. You also need to have low oxygen levels and signs of a lung infection.

To be considered, you should already be on a small amount of oxygen (at least 2 litres per minute) through a nose tube to keep your oxygen levels above 90%. However, you won't be able to join if you already need a lot of oxygen (more than 8 litres per minute) through a nose tube, or if you're already using the high-flow Optiflow device before the study starts. You also can't take part if you have a nose problem that would stop you from using the Optiflow tube, or if you have certain severe breathing problems like high carbon dioxide levels or very acidic blood, or if you've needed a different type of breathing support (NIV) for a long time or have been on a breathing machine.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Are you scheduled for a bronchoscopy?
Do you have a weakened immune system (e.g., from certain cancers or a stem cell transplant)?
Do you have a lung infection and need oxygen to keep your levels up?
Are you able to use a nasal tube for oxygen without a problem with your nose?
Do you not currently need very high amounts of oxygen (more than 8 litres/minute) or have certain severe breathing problems?

Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, you will be randomly assigned to receive either the usual low-flow oxygen or the 'Optiflow' high-flow oxygen through tubes in your nose during your scheduled bronchoscopy. This is a single procedure, so there are no additional study visits or medications beyond your normal care. Researchers will monitor your oxygen levels and breathing closely during the bronchoscopy. The total duration of your involvement in the study will be focused on the time you are undergoing the bronchoscopy procedure itself.

Potential risks and benefits

Taking part in this study might help researchers understand a better or safer way to provide oxygen during a bronchoscopy for patients with weakened immune systems, potentially preventing drops in oxygen levels. However, as with any medical procedure, there are always potential risks; the researchers will discuss these with you in detail. You might experience the same possible risks as any patient undergoing a bronchoscopy and receiving oxygen. You are free to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (1)

Mount Sinai Hospital
Verified postcode
Toronto, Canada

Common questions

What is a bronchoscopy?

A bronchoscopy is a medical test where a doctor uses a thin, flexible tube with a camera to look inside your lungs and collect samples, usually to find out what's causing a lung infection.

What does 'immunocompromised' mean?

It means your body's immune system, which fights off infections, is weaker than usual. This can happen with certain illnesses or treatments.

What is 'Optiflow'?

Optiflow is a special device that delivers a higher amount of warm, moist oxygen through soft tubes that fit comfortably in your nose.

Will I know which oxygen method I'm getting?

Because this is a randomised study, you will be assigned by chance to either the standard oxygen method or the Optiflow method, and you will know which one you are receiving.

Will this study change my regular treatment?

No, this study is comparing two ways of giving oxygen during a test you're already scheduled for. It won't change your overall treatment plan for your lung infection.