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Trial registered on ANZCTR
Registration number
ACTRN12610000522011
Ethics application status
Approved
Date submitted
23/06/2010
Date registered
24/06/2010
Date last updated
8/06/2021
Date data sharing statement initially provided
8/06/2021
Date results provided
8/06/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
High flow oxygen therapy in obese hospitalised patients: effects on carbon dioxide levels in the blood.
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Scientific title
A randomised, controlled crossover trial of the effect of high concentration oxygen on transcutaneous carbon dioxide tension in obese hospitalised patients.
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Secondary ID [1]
252079
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hypercapnia as a consequence of oxygen therapy in obese individuals.
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Condition category
Condition code
Diet and Nutrition
257798
257798
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0
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Obesity
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Respiratory
257811
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Oxygen via face mask at 8L/min for 60 minutes, with recorded measurements of heart rate, respiratory rate, oxygen saturations and transcutaneous carbon dioxide (PtCO2) levels at baseline, 10, 20, 30, 40, 50 and 60 minutes. Subjects will also have these parameters continuously monitored during the intervention, with cessation of the intervention immediately should PtCO2 exceed 10mmHg from baseline
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Intervention code [1]
256703
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Treatment: Other
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Intervention code [2]
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Prevention
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Comparator / control treatment
Oxygen adjusted to the minimal rate required to keep oxygen saturations of 88 to 92 % for 60 minutes. Measurements will be recorded of heart rate, respiratory rate, oxygen saturations and transcutaneous carbon dioxide (PtCO2) levels at baseline, 10, 20, 30, 40, 50 and 60 minutes. Subjects will also have these parameters continuously monitored during the intervention, with cessation of the intervention immediately should PtCO2 exceed 10mmHg from baseline.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Change in PtCO2 from baseline. PtCO2 and oxygen saturation (SpO2) are assessed via a combined SpO2/PtCO2 non-invasive monitor (SENTEC (SenTec AG, Switzerland)).
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Assessment method [1]
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Timepoint [1]
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PtCO2 levels will be recorded at baseline and at the following times from onset of the intervention: 10 mins, 20 mins, 30 mins, 40 mins, 50 mins and 60 mins.
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Secondary outcome [1]
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Proportion of subjects who have a change in PtCO2 from baseline of greater than or equal to 4mmHg.
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Assessment method [1]
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Timepoint [1]
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This will be assessed from the recorded data taken from each subject at baseline, 10 mins, 20 mins, 30 mins, 40 mins, 50 mins and 60 mins.
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Secondary outcome [2]
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Rate of change of PtCO2.
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Assessment method [2]
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Timepoint [2]
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This will be assessed from the recorded data taken from each subject at baseline, 10 mins, 20 mins, 30 mins, 40 mins, 50 mins and 60 mins of intervention.
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Secondary outcome [3]
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Change in Respiratory Rate from baseline. Assessed by investigator count.
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Assessment method [3]
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Timepoint [3]
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Taken from each subject at baseline, 10 mins, 20 mins, 30 mins, 40 mins, 50 mins and 60 mins of intervention.
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Secondary outcome [4]
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Change in Heart Rate from baseline. Assessed by SENTEC.
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Assessment method [4]
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Timepoint [4]
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Taken from each subject at baseline, 10 mins, 20 mins, 30 mins, 40 mins, 50 mins and 60 mins of intervention.
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Secondary outcome [5]
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Change in Oxygen Saturation from baseline. Assessed by SENTEC.
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Assessment method [5]
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Timepoint [5]
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Taken from each subject at baseline, 10 mins, 20 mins, 30 mins, 40 mins, 50 mins and 60 mins of intervention.
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Eligibility
Key inclusion criteria
1. Current internal medicine inpatient in Wellington Hospital; 2. Age >/= 16 years; 3. Body Mass Index (BMI) > 40kg/m2.
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Diagnosis of Chronic Obstructive Pulmonary Disease (COPD); 2. Ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV1:FVC) < 0.7 (First 24 participants recruited only); 3. Patients currently receiving treatment with Continuous Positive Airway Pressure (CPAP) ventilation or Non-Invasive Positive Pressure Ventilation (NIPPV); 4. Patients currently requiring >2L/minute of oxygen therapy following titration to the recommended target saturation range of 88-92% (First 24 participants recruited only); 5. Patients with baseline PtCO2 of >65mmHg; 6. Current diagnosis of disease causing restriction to chest wall expansion, other than obesity i.e. neuromuscular disease or chest wall dysfunction; 7. Administration of respiratory suppressant medications, including opiate analgesia and benzodiazepines within 24 hours (First 24 participants recruited only); 8. Patients with unstable angina or recent myocardial infarction.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The study will be explained by the study investigator(s) verbally and with written information in the form of a participant information sheet provided in advance. Informed consent in written form will be obtained and the participant will be screened for eligibility. A randomisation sequence, determining the order in which the subjects receive the interventions, will be generated by a statistician. A third party, not directly involved with the study, will then file these sequences into 24 (24 = target subject number) sealed uniform opaque envelopes. Study investigators will have had no involvement with the generation of these envelopes. If eligible, subjects will be randomised to the order in which they receive their interventions as determined by one of the envelopes.
Note the above will occur for both the 24 participants recruited under tight exclusion criteria and the 24 participants recruited under fewer exclusion criteria.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The random selection from a remotely generated set of uniform envelopes, each allocating the order in which to apply the interventions.
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
15/11/2011
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Actual
15/11/2011
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Date of last participant enrolment
Anticipated
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Actual
7/09/2015
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Date of last data collection
Anticipated
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Actual
7/09/2015
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Sample size
Target
48
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Accrual to date
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Final
48
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
2708
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Funding & Sponsors
Funding source category [1]
257169
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Charities/Societies/Foundations
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Name [1]
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Medical Research Institute of New Zealand (MRINZ)
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Address [1]
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Level G
Clinical Services Block
Wellington Hospital
Riddiford Street
Newtown
Wellington 6021
POSTAL: Private Bag 7902, Wellington 6242
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Country [1]
257169
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New Zealand
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Primary sponsor type
Charities/Societies/Foundations
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Name
Medical Research Institute of New Zealand
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Address
Level G
Clinical Services Block
Wellington Hospital
Riddiford Street
Newtown
Wellington 6021
POSTAL: Private Bag 7902, Wellington 6242
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
256426
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Other collaborator category [1]
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Hospital
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Name [1]
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Capital & Coast District Health Board
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Address [1]
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Wellington Hospital
Riddiford Street
Wellington 6021
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Country [1]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central Regional Ethics Committee
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Ethics committee address [1]
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Ministry of Health Level 2, 1-3 The Terrace PO Box 5013 Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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19/05/2010
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Ethics approval number [1]
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CEN/10/03/08
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Summary
Brief summary
Overweight individuals are at increased risk of a number of complications including obesity hypoventilation syndrome (OHS). It has been shown that high concentration oxygen therapy increases arterial carbon dioxide tension (PaCO2) levels in patients with OHS. We now seek to determine whether a similar response occurs in obese subjects, regardless of whether or not they have OHS. This would be relevant to clinical practice as obese patients presenting to hospital with an acute medical condition may routinely given high flow oxygen therapy. This study aims to investigate whether the administration of high concentration oxygen leads to carbon dioxide retention in a group of obese hospital inpatients.
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Trial website
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Trial related presentations / publications
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Public notes
One of the transcutaneous TOSCA probes used in data collection for the first set of 24 participants was found to require re-surfacing when subsequently reviewed by the manufacturer. Another of the probes used during that time was advised not to be used further following ongoing difficulty with calibration. It is uncertain the extent to which the condition of these probes may have affected the accuracy of the data collected. The study was repeated, and only the data from the second set of 24 participants is to be analysed and submitted for peer reviewed publication.
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Contacts
Principal investigator
Name
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Dr Kyle Perrin
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Address
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C/O J Pilcher
Medical Resaerch Institute of New Zealand
Private Bag 7902
Wellington 6242
New Zealand
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Country
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New Zealand
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Phone
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+64 4 8050241
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Janine Pilcher
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Address
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C/O J Pilcher
Medical Research Institute of New Zealand
Private Bag 7902
Wellington 6242
New Zealand
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Country
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New Zealand
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Phone
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+64 4 8050241
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Janine Pilcher
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Address
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C/O J Pilcher
Medical Research Institute of New Zealnd
Private Bag 7902
Wellington 6242
New Zealand
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Country
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New Zealand
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Phone
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+64 4 8050241
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
High flow or titrated oxygen for obese medical inpatients: A randomised crossover trial.
2017
https://dx.doi.org/10.5694/mja17.00270
N.B. These documents automatically identified may not have been verified by the study sponsor.
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