The Incidence of Respiratory Symptoms Associated With the Use of HFNO

Study Overview
=================
Brief Summary
-----------------
Optiflow (high flow humified nasal oxygen) is used in several settings frequently (ICU, during elective general anaesthesia- commonly here on the TOE list, in certain ENT patients, and more commonly now in obese or obstetric patients for preoxygenation). To the investigators knowledge no one has quantified the common complications associated with it (based on a literature search in November 2017 using PubMed and Google; using the search terms high flow nasal oxygen combined with complications, side effects, nasal dryness and epistaxis). The investigators were unable to find any existing research that examined the days following HFNO use and specifically looked for minor side effects) The investigators have had anecdotal feedback from patients that they tend to experience respiratory symptoms post HFNO. THe investigators would like to determine how often this occurs and how long it lasts for which would be pertinent to consent, and informing patients prior to the procedure, and also serve to improve the literature on this up and coming technique.

Detailed Description
-----------------
The study aims to evaluate what is the frequency and severity of respiratory tract symptoms following the use of high flow nasal humidified oxygen? Participants will be from 2 sub groups: Patients already undergoing TOE (as this is the most common and consistent group who have optiflow- about 4-5 patients per week) Volunteers (staff) who would agree to experience the optiflow whilst awake for the same period as those undergoing TOE The study will involve a 7 day follow up survey to see if they had experienced complications (runny nose, nasal discomfort, sore throat, epistaxis), what their severity was and how long they lasted for.

Official Title
-----------------
The Incidence and Severity of Upper Respiratory Tract Symptoms Associated With The Use of High-Flow Humidified Nasal Oxygen (HFNO)

Conditions
-----------------
Cardiovascular Diseases

Intervention / Treatment
-----------------
* Device: High-Flow Humidified Nasal Oxygen


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion criteria: Volunteers (staff) - from the anaesthetics department and willing to be exposed to HFNO Patients listed for all those undergoing elective TOE requiring sedation and use of HFNO present at Torbay Hospital Greater than 18 years of age. No upper age limit Able to give informed consent Exclusion Criteria: patient refusal lack of capacity poor understanding of English respiratory tract symptoms blocked nostrils current or recurrent epistaxis nasal steroid treatment Ages <18 years Unable to give informed consent

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 2 sub group will be recruited: patient undergoing TOE Staff volunteers
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: High-Flow Humidified Nasal Oxygen - TOE participants<br>High-Flow Humidified Nasal Oxygen - standard care | Device: High-Flow Humidified Nasal Oxygen<br>* High-Flow Humidified Nasal Oxygen<br>|
| Active Comparator: High-Flow Humidified Nasal Oxygen<br>High-Flow Humidified Nasal Oxygen - staff volunteers | Device: High-Flow Humidified Nasal Oxygen<br>* High-Flow Humidified Nasal Oxygen<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of respiratory tract symptoms | telephone survey after 7 days | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| severity of respiratory tract symptoms | telephone survey after 7 days | 7 days |