Evaluation on the Efficacy of Bronchodilator Nebulization Via High Flow Nasal Cannula

Study Overview
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Brief Summary
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High-humidity nasal cannula (HFNC) has been shown to be effective in improving oxygenation and avoiding intubation in multiple randomized control trials, it is also suitable and feasible for long term use. Aerosol delivery via HFNC will minimize interruptions and improve patient compliance, bench study and radionuclide imaging study done in healthy volunteers demonstrated that aerosol can be effectively delivered using HFNC. This study aims to evaluate the efficacy of bronchodilator delivered via HFNC in chronic pulmonary obstructive disease or asthma patients.

Detailed Description
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Chronic obstructive pulmonary disease or asthma patients who have positive response in bronchodilator test will be consented and enrolled, patients come back for the second bronchodilator assessment within one to three days after the initial bronchodilator test. Albuterol with different concentration will be provided to the patients via HFNC, patients will be assessed by spirometry after each concentration until bronchodilator response is positive and does not improve after the next dose.

Official Title
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Evaluation on the Efficacy of Bronchodilator Nebulization Via High Flow Nasal Cannula

Conditions
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High Flow Nasal Cannula

Intervention / Treatment
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* Device: High flow nasal cannula
* Drug: Albuterol Sulfate


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnose with COPD or asthma Bronchodilator test is positive (According to ATS guidelines, FEV1 change from initial more than 12% and FEV1 absolute change more than 200 mL); Age > 18yrs and < 90yrs Exclusion Criteria: Recent pulmonary exacerbation Mental disease Uncooperative Reluctant to participate Patients who are unable to come back to get the second spirometry within three days Contraindicated to Albuterol (Ventolin, GSK) Rest HR > 100 beats/min Serum K+ < 2.8 mmol/L

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Albuterol via High flow nasal cannula<br>Enrolled patients inhale bronchodilator (Albuterol Sulfate) with different concentration via High flow nasal cannula, prepared albuterol concentrations are 0.5mg, 1.0mg, 2.0mg and 4.0mg, patients will be assessed by spirometry after each concentration until bronchodilator response is positive and does not improve after the next dose. | Device: High flow nasal cannula<br>* High flow nasal cannula is a soft and flexible nasal prongs with adjustable head strap fits over the patient's ears, it delivers a broad variety of gas flows directly into the nares without gas jetting.<br>* Other names: Optiflow, Fisher Paykel;Drug: Albuterol Sulfate<br>* Albuterol is a short acting inhaled bronchodilator<br>* Other names: Ventolin;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| FEV1 change from initial | FEV1 abs Δ: post FEV 1 - pre FEV1 and FEV1 %Δinit: (post FEV1 - pre FEV1)/pre FEV1 × 100 | 30-60 mins | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breath sound | Wheezing | 30-60 mins | 
| Heart rate | The number of heart beats per minute | 30-60 mins | 
| Respiratory rate | About 4,630,000 results (0.68 seconds) Search Results The number of breaths per minute | 30-60 mins | 
| Side effects | Tremor | 30-60 mins |