Comparing Asymmetric DUET and Conventional Nasal High Flow Devices for Treating Mild to Moderate Acute COPD Exacerbation with Hypercapnia A Randomized Crossover Clinical Trial

What this Trial Is About

Researchers are evaluating two types of nasal high flow oxygen devices in adults with chronic obstructive pulmonary disease COPD who are experiencing a mild to moderate worsening of their breathing symptoms with high carbon dioxide levels. The study aims to compare the new asymmetric nasal high flow interface called DUET with the standard conventional nasal high flow cannula. Key questions include whether the asymmetric interface better reduces carbon dioxide levels, lowers breathing rate and discomfort, decreases the need for advanced oxygen therapies, and maintains similar comfort and vital signs compared to the conventional device. In this randomized crossover trial, 50 patients with COPD exacerbation and mild to moderate hypercapnic respiratory failure will receive both treatments in sequence. Half will start with the DUET asymmetric nasal cannula for 3 hours followed by the conventional cannula for 3 hours after a 30-minute break, while the other half will receive the devices in the reverse order. Both devices deliver heated oxygen at 60 liters per minute and 37C, adjusted to keep oxygen saturation between 88% and 92%. Patients will be monitored closely in a semi-reclined position using the same equipment model. Participants will undergo several assessments including blood tests to measure carbon dioxide levels, respiratory rate, heart rate, blood pressure, breathing comfort, and dyspnea scores before and after each treatment period. Continuous monitoring with pulse oximetry, carbon dioxide sensors, and respiratory motion sensors will track breathing patterns. Researchers will also evaluate tolerance by measuring noise, dryness, and overall comfort. The goal is to determine which device better supports breathing while maintaining patient comfort. The trial is conducted under strict clinical regulations with safety measures allowing switch to more advanced ventilation if needed.

DUET Versus Standard Interface for Hypercapnic COPD Patients