Effects of Automated Adjustment of FiO2 on Cerebral and Arterial Oxygenation in Preterm Infants (FiO2-Contr)
Effects of Automated Adjustment of Inspired Oxygen on Fluctuations of Regional Cerebral and Arterial Oxygenation in Preterm Infants With Frequent Desaturations
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Ulm, Germany, 89070
- Children's Hospital University of Ulm
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- postmenstrual age <30 wks GA at study time
- on nasal/nasopharyngeal CPAP or mechanical ventilation (including nasopharyngeal IMV)
- at least 4 desaturations (SpO2 <80%) during an 8 hour period within the 24h before the study using a standard pulse oximeter incorporated in the NICU (Dash 3000, General Electric, Freiburg; 10s averaging time, delay 10s)
Exclusion Criteria:
- postnatal age <96h (to exclude rapidly changing conditions during the early phase of RDS and to avoid handling of the infant during the critical period for IVH)
- congenital cyanotic heart disease
- no decision for full treatment support
- Average FiO2 during the last 24h bevor the active study phase >0.60
- Congenital malformations of the lung or the diaphragm (i.e. diaphragmatic hernia, congentital cystic lung diseases...)
- Clinically clear evidence for seizures
- Ongoing Sepsis (CRP > 10mg/l, or positive blood culture, requirement of catecholamines)
- Need of blood-transfusion during study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: CROSSOVER
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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EXPERIMENTAL: Automated FiO2 control
Infants will be changed to a specific ventilator device approved for clinical use in neonates in Germany (Avea, Carefusion 234 GmbH Hoechberg, Germany), which is capable to automatically adjust the FiO2 based on readings of an incorporated SpO2 monitoring device.
Infants will be allowed to adjust for at least 2h using the ventilator settings as chosen by the clinical team responsible.
Thereafter, data will be recorded for 24h experimental time.
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Infants will be ventilated with or without automated FiO2-Control in a randomized sequence.
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PLACEBO_COMPARATOR: Manual Adjustment
Infants will be exposed to the first study phase (clinical routine or automated FiO2 adjustment) for 24 h and then will be switched to the alternate mode (automated FiO2 adjustment or clinical routine) for another 24 h.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Cerebral tissue oxygen saturation
Time Frame: 48 hours
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mean cerebral tissue oxygen saturation as well als distribution of cerebral tissue oxygen saturation over time will be assessed
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48 hours
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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number and mean duration of episodes with an SpO2 <80%, <75%, <70% and with hyperoxemia (SpO2 >96%)
Time Frame: 48 hours
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The number and mean duration of expisodes of desaturation and with hyperoxemia will be assessed
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48 hours
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time within a defined target range of cerebral oxygen saturation (59% - 81%)
Time Frame: 48 hours
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time (as measured as the percentage of the total recording time) within a defined target range of cerebral oxygen saturation (59% - 81%) which corresponds to the 10th and 90th percentile obtained from a pilot study in 16 preterm infants with desaturations during the time when their SpO2 was aimed within the target range of a SpO2 of (88-96%).
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48 hours
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workload for the medical staff related to number of adjustments of FiO2
Time Frame: 48 hours
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48 hours
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Markus Waitz, MD, Children's Hospital, University of Ulm
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- FiO2_Ulm
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