High Flow humidified Oxygen in Paediatric Severe Asthma
Trial acronym: HOPSA
Description
Asthma affects 1 in 11 UK children; one of the commonest reasons children attend hospital emergency departments is for an asthma attack. Many children do not respond to initial treatment (high dose inhalers) and need extra treatment: this usually requires a needle to be placed into a vein (intravenous therapy) which is distressing and has unpleasant side effects.
High flow humidified oxygen (HiFlo) is a new treatment which delivers lots of moist air with added oxygen, through short soft tubes fitting into the nostrils. It helps with breathing and keeps the airways open and moist. It is more comfortable than other ways to support breathing and has a good safety record. HiFlo is already being used in other childhood breathing problems and for treating severe asthma attacks when other therapy hasn’t worked.
This study will find out whether starting HiFlo early (within 4 hours of initial treatment) speeds up recovery from a severe asthma attack and reduces the need for unpleasant intravenous therapy. We have already carried out a successful small version which showed that this study is feasible, and told us how many children and hospitals will be needed to get a clear answer on whether using early HiFlo is beneficial for children with a severe asthma attack.
The trial will involve 218 children (aged 2–17 years) who come to hospital with a severe asthma attack. Half the children will receive early HiFlo as extra therapy and half will receive usual care. No extra blood tests will be needed.
We will compare children on early HiFlo with those receiving usual care. We will see whether they need less intravenous treatment, improve more rapidly, are ready to go home sooner, and experience less distress and side effects.
Study design: Open-label, two arm, individually randomised, parallel group trial
Disease area: Paediatrics
Trial status: In set up
Chief Investigators: Dr Akshat Kapur, Prof Paul Seddon
Sponsor: University Hospitals Sussex
Funder: NIHR RfPB
Start date: 01/07/2025
End date: 30/06/2028
Recruitment target: 218
For further information contact:
E: ctu-hopsa@bsms.ac.uk