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Browse 1,501 clinical trials for copd. Find studies that match your criteria and connect with research centers.
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NCT03222271
Invasive mechanical ventilation (IMV) is associated with numerous complications. Hence, patients should be weaned from the ventilator as early as possible. A number of randomized controlled trials have addressed whether noninvasive ventilation (NIV) can facilitate weaning in patients failing spontaneous breathing trials (SBT)s. Compared to invasive weaning, NIV weaning strategy showed reduced mortality, greater weaning success, less ventilator-associated pneumonia, shorter length of ICU and hospital stay and less re-intubation rate. Most of the previous studies used pressure support ventilation with fixed pressure support, but no studies published on hybrid NIV modes. Intelligent Volume Assured Pressure Support (iVAPS) is a recent NIV mode, which achieves a target alveolar ventilation by adjusting pressure support and respiratory rate automatically. In iVAPS, the target is alveolar ventilation not the tidal volume, taking into account a predicted dead space . This new mode has been investigated in stable chronic obstructive pulmonary disease (COPD) patients with domiciliary NIV and it was comparable to pressure support ventilation (PSV) regarding improvement in oxygenation, carbon dioxide (CO2) wash and therapy compliance. Yet, less numerous studies have been performed on this mode when used for acute respiratory failure. These studies found that i-VAPS was comparable to PSV as regards PaCO2 and pH improvements, minute volume, pressure support and respiratory rate. No published data so far about the role of i-VAPS as a weaning mode in mechanically ventilated patients. So, this study aims to investigate this new mode in comparison to the standard S/T mode in weaning COPD patients using NIV.
NCT04694729
Pulmonary rehabilitation (PR) is a first-line management strategy in chronic obstructive pulmonary patients (COPD) as it reduces shortness of breath, increases exercise capacity, and improves health-related quality of life. However, 8-50% of patients referred to PR do not participate at all, while 10-32% of those who start do not complete the program. Barriers to participation and completion include difficulty in accessing the program, poor mobility, lack of transport, and travel costs. Telerehabilitation is defined as the provision of rehabilitation services through telecommunication technology, including telephone, internet and video conference communications between the patient and the healthcare provider. Different technologies (from phone to video conferencing) have been tested in patients with COPD to enhance daily activities, exercise training and walking prescription. All of them showed positive effects on exercise tolerance, dyspnea, physical activity and quality of life. However, there is no study about which telerehabilitation program is more effective on COPD patients. The aim of this study is to investigate which telerehabilitation approach is more effective in COPD.