HYPERACT Trial Published: A Paradigm Shift in Respiratory Care
December 12, 2024
The publication of “High-Velocity Nasal Insufflation vs Non-Invasive Positive Pressure Ventilation for Moderate Acute Exacerbation of COPD in the ED”
Exeter, NH – Vapotherm is proud to announce the publication of the HYPERACT (HYPERcapnia: A Randomized Clinical Trial) study in Academic Emergency Medicine, making this important data available to all clinicians worldwide.
This multi-center randomized controlled trial demonstrates that high velocity therapy is a viable alternative to Noninvasive Positive Pressure Ventilation (NiPPV) for treating moderate-to-severe hypercapnic respiratory distress in emergency department (ED) patients with COPD, with significant benefits for patient comfort and tolerability.
(Photo NiPPV/Mask-based therapy left, Small-bore/high velocity therapy right)
Led by Principal Investigators Dr. Andrew Meltzer and Dr. David Yamane, the HYPERACT trial challenges long-standing respiratory care practices, offering a new approach to managing acute COPD exacerbations. The findings were initially presented by Dr. Yamane at the Society of Critical Care Medicine’s Annual Congress, where he received the prestigious Star Research Award.
Transforming Emergency Department Practice
Dr. Yamane, who is also the Associate Professor of Emergency Medicine at George Washington University, reflected on the study’s transformative impact:
“The results of the HYPERACT trial were both surprising and practice changing. At George Washington, we’ve already begun integrating high velocity therapy into our protocols, and the difference in patient comfort and outcomes is evident. This therapy is an invaluable tool for emergency care teams managing COPD patients with hypercapnic respiratory distress.”
(Photo of Dr. Yamane at SCCM, receiving the Star Research Award)
Dr. Andrew Meltzer, also a professor at George Washington University, further comments, “Well, it isn’t so surprising. When a patient arrives to the ED gasping for air, a mask-based therapy is terrifying. It’s only one study, but I hope this is enough to encourage other physicians to consider high velocity therapy.”
Key Study Highlights
Primary Outcome: High velocity therapy was non-inferior to NiPPV in reducing dyspnea (as measured on a modified Borg Scale) over four hours.
Secondary Outcomes: Comparable improvements in pH and pCO2 between high velocity therapy and NiPPV (with baseline CO2 up to 120 mmHg).
Patient Comfort: Statistically superior comfort ratings for high velocity therapy at all time points.
Discharge Rates: 11% of patients on high velocity therapy were discharged home directly from the ED, compared to none in the NiPPV group.
Tolerance: High velocity therapy was better tolerated, with fewer patients discontinuing therapy due to intolerance (11% vs.19% with NiPPV).
Implications for the Future of Respiratory Care
HYPERACT is the first multi-center RCT to focus on patients with moderate-to-severe hypercapnic respiratory failure. By addressing limitations of traditional mask-based therapies, such as discomfort, aspiration risk, and cardiovascular instability, high velocity therapy offers a patient-friendly alternative that aligns with evidence-based medicine.
Commenting on the study, Dr. Jessica Whittle, Vapotherm’s Chief Medical Officer, said:
“Publishing the HYPERACT trial is an important milestone, but it isn’t enough. The next step is ensuring clinicians are educated on these findings and equipped to implement evidence-based medicine in their practices. This study challenges the status quo and highlights the importance of considering innovative solutions like high velocity therapy.”
Download HYPERACT One-Pager here.
Read HYPERACT Study here.
About Vapotherm, Inc
Vapotherm, Inc. based in Exeter, NH, is dedicated to improving respiratory care through innovation and clinical excellence. By developing advanced solutions like high velocity therapy, Vapotherm empowers healthcare providers to deliver superior patient outcomes while enhancing the care experience.
For more information on the HYPERACT trial or to access the open-access publication, visit: https://onlinelibrary.wiley.com/doi/full/10.1111/acem.15038
Medical Affairs Contact:
Jessica Whittle, MD PhD
Chief Medical Officer | VP Clinical Research | Vapotherm, Inc.
100 Domain Drive, Exeter, NH 03833
Cell: 407-920-4641 | Email: [email protected]
SOURCE Vapotherm, Inc.
CAUTION: US Federal law restricts this device to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at https://vapotherm.com/resources/support/precision-flow-reference/. For spontaneously breathing patients. High Velocity Therapy (HVT) does not provide total ventilatory requirements of the patient. It is not a ventilator. Decisions surrounding patient care depend on the physician’s professional judgment in consideration of all available information for the individual case, including escalation of care depending on patient condition.