Interest of High Flow Nasal Cannula (HFNC) Versus Non Invasive Ventilation During the Initial Management of Severe Bronchiolitis in Infants (TRAMONTANE)
- The purpose of the study is to evaluate prospectively the clinical benefits of High flow nasal canula (HFNC: 2l/kg/min) versus nasal CPAP( continuous positive airway pressure) (n-CPAP: 7 cmH2O) in the initial management of bronchiolitis in infants.
- Design: non-inferiority study, prospective, controlled, randomized, multi-center.
- Design: Infants less than 6 month admitted in pediatric intensive care unit for respiratory distress (mWCAS >3) secondary to bronchiolitis but not requiring mechanical ventilation will be randomized in two groups: "n-CPAP"(nasal continuous positive airway pressure) or "HFNC" during 24 hours.
Conditions of measurements:
Primary endpoint: Proportion of failure in both arms during the first 24 hours. Failure criteria: A raise of the Clinical score for respiratory distress (mWCAS) (1 point) or respiratory rate (10/min /H0 and above 60/min) or discomfort (EDIN) (1point /H0 and above 4) or apnea.
Secondary outcomes: Assessment at H1, H12, H24 of mWCAS, respiratory and heart rate, EDIN score, skin lesions, FiO2 (fraction of inspired oxygen
) required to achieve an oxygen saturation between 94 and 97%, transcutaneous PCO2 (carbon dioxide partial pressure) (correlated to an initial gas analysis), Report SpO2 / FiO2
- Statistic: Intention to treat Analysis. Expected number of patients: 71 per arm: 142 children.
- Study Schedule: October 2014-April 2016
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Christophe MILESI, Doctor
- Phone Number: 0033467336609
- Email: c-milesi@chu-montpellier.fr
Study Locations
-
-
-
Montpellier, France, 34395
- Recruiting
- University Hospital of Montpellier
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- age<6months
- bronchiolitis
- mWCAS > or=3
- hospitalisation in pediatric intensive care unit
- signed consent form (2 parents)
Exclusion Criteria:
- Intubated patient
- Neurological or cardiac disease
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: HFNC treatment
HFNC : High flow nasal canula 24hours Patients will be treated by a High flow nasal canula (HFNC: 2l/kg/min) for the initial management of their bronchiolitis (24 hours)
|
Hygh flow nasal canula HFNC
|
|
Active Comparator: nCPAP treatment
nCPAP : nasal NCPAP Patients will be treated by a nasal CPAP (n-CPAP: 7 cmH2O) for the initial management of their bronchiolitis (24 hours)
|
nasal nCPAP
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of failure
Time Frame: 24 hours
|
Proportion of failure in both arms during the first 24 hours.
A raise of the Clinical score for respiratory distress (mWCAS) (1 point) or respiratory rate (10/min /H0 and above 60/min) or discomfort (EDIN) (1point /H0 and above 4) or apnea.
|
24 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
number of participants with an aggravation of the clinical score for respiratory distress arms
Time Frame: 1hour
|
comparison of the clinical score for respiratory distress (mWCAS) in both arms
|
1hour
|
|
number of participants with an aggravation of the clinical score for respiratory distress arms
Time Frame: 12hours
|
comparison of the clinical score for respiratory distress (mWCAS) in both arms
|
12hours
|
|
number of participants with an increase of the clinical score for respiratory distress arms
Time Frame: 1 hour
|
Assessment of Report Sp02/Fi02in both arms
|
1 hour
|
|
Comparison of the Report Sp02/Fi02 in both arms
Time Frame: 1 hour
|
Assessment of Report Sp02/Fi02in both arms
|
1 hour
|
|
Comparison of the Report Sp02/Fi02 in both arms
Time Frame: 12 hours
|
Assessment of Report Sp02/Fi02in both arms
|
12 hours
|
|
Comparison of the Report Sp02/Fi02 in both arms
Time Frame: 24 hours
|
Assessment of Report Sp02/Fi02in both arms
|
24 hours
|
|
number of participants with skin lesions in both arms
Time Frame: 1 hour
|
number of participants with skin lesions in both arms and classification of the lesions with the National Pressure Ulcer Advisory Panel (NPUAP)
|
1 hour
|
|
number of participants with skin lesions in both arms
Time Frame: 12 hours
|
number of participants with skin lesions in both arms and classification of the lesions with the National Pressure Ulcer Advisory Panel (NPUAP)
|
12 hours
|
|
number of participants with skin lesions in both arms
Time Frame: 24 hours
|
number of participants with skin lesions in both arms and classification of the lesions with the National Pressure Ulcer Advisory Panel (NPUAP)
|
24 hours
|
|
number of participants with Discomfort in both arms
Time Frame: 1 hour
|
Assessment of the discomfort in both arms with the score of EDIN
|
1 hour
|
|
number of participants with Discomfort in both arms
Time Frame: 12 hours
|
Assessment of the discomfort in both arms with the score of EDIN
|
12 hours
|
|
number of participants with Discomfort in both arms
Time Frame: 24 hours
|
Assessment of the discomfort in both arms with the score of EDIN
|
24 hours
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
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
- 9433
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