Portable Continuous Positive Airways Pressure (CPAP) in Excessive Central Airway Collapse (ECAC) Study

Launched by PAPWORTH HOSPITAL NHS FOUNDATION TRUST · Oct 3, 2023

Keywords

ClinConnect Summary

The Portable Continuous Positive Airways Pressure (pCPAP) study is looking at how a new, lightweight breathing device can help people with Excessive Central Airway Collapse (ECAC). This condition causes the airways in the chest to partially or completely collapse during exhalation, making it hard for patients to breathe, especially during physical activities. The study aims to see if using the pCPAP device can improve exercise ability and reduce breathlessness for those affected by ECAC. Currently, treatments are limited, and standard machines usually only help at night or when resting.

To participate, individuals must be over 18, have a diagnosis of ECAC confirmed by imaging tests, and experience significant breathlessness. Participants will attend two visits at The Royal Papworth Hospital, where they will perform a walking test with and without the pCPAP device to see how it affects their breathing and activity levels. The study also hopes to understand how well patients can use the device in their daily lives. Overall, this research could provide valuable insights into a new way to manage symptoms for people with this challenging condition.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Diagnosis of ECAC based on \>50% reduction of the antero-posterior diameter of large airways demonstrated on dynamic CT thorax or bronchoscopy. Only patients with tracheal and/or bilateral large bronchi (main to lobar) involvement will be included.
• • 2. Symptoms of dyspnoea felt to be predominantly caused by ECAC (where ECAC is the only respiratory pathology or dyspnoea is clearly out of proportion to a co-morbid respiratory condition)
• • 3. Medical Research Council (MRC) breathlessness scale of 3 (I stop for breath after walking about 100 yards or after a few minutes on level ground) or more.
• • 4. Age over 18 years
• • 5. Able to give informed consent -
• Exclusion Criteria:
• • Patients with dynamic collapse of only segmental airways
• • Comorbidity which is likely to be an additional limiting factor in exercise tolerance
• • Contraindication to CPAP
• • Contraindication to incremental shuttle walk testing (ISWT), including; myocardial infarction within the last 3-5 days, unstable angina, uncontrolled arrhythmia, severe symptomatic cardiac or valvular disease, acute pulmonary embolus, uncontrolled asthma, syncope, mental impairment resulting in inability to perform test.
• • Resting oxygen saturations \<90% on air or need for ambulatory oxygen therapy
• • Immobility that would make ISWT unfeasible
• • Severe emphysema
• • Acute infectious disease
• • Acute respiratory illness