Abstract Details

Title Demand Valve Oxygen: A Promising New Oxygen Delivery System for the Acute Treatment of Cluster Headache

Topic Headache

Presentation(s) P01 - (-)

Poster/Presentation
Number 078

Objective

Background DVO delivers oxygen to the user as soon as they inhale from an attached mask thus dosage is controlled by respiration rate. DVO is capable of delivering oxygen upto 160 LPM. One benefit of DVO is that it can support hyperventilation. Hyperventilation leads to hyperoxia and hypocapnia. Both conditions cause cerebral arterial vasoconstriction; a possible mechanism by which CH pain is relieved. Hyperoxia also inhibits neurogenic inflammation elicited by trigeminal ganglion stimulation.

Design/Methods Single center, open-label, 2-period, 2-treatment, cross-over design. Subjects randomized to 1 of 2 sequences: first headache treated with CFO (15 LPM) and subsequent with DVO, or vice versa. Treatment began when pain was at least moderate and stopped after 30 minutes. Subjects assessed pain at multiple time points. Subjects were taught a specific breathing technique for the demand valve arm (initial phase of hyperventilation). Primary endpoint was headache response (moderate to severe pain reduced to mild or none).

Results Three subjects (2 M, 1 F) completed trial; a fourth completed DVO only. All had chronic CH. Study halted because of poor recruitment. On DVO all subjects became pain free (time in minutes: 15, 19, 6, 8); 2 of 3 became pain free on CFO (time in minutes:20, 10) the third subject needed 30 minutes to get to mild pain.

Conclusions Based on a small sample size DVO appears to be an effective acute treatment for CH. All subjects on DVO became headache free. Time to pain freedom was fast (average 12 minutes). DVO was more efficacious than CFO as it provided a faster time to headache response (10 minutes vs 18 minutes) and was more likely to produce pain freedom.

Authors/Disclosures
Todd D. Rozen, MD, FAAN (Mayo Clinic) PRESENTER	No disclosure on file
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.

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