A Comparison of Methods of Discontinuing Nasal CPAP in Premature Infants <30 Weeks Gestation

February 29, 2020 updated by: Amir Mustafa Khan, The University of Texas Health Science Center, Houston

A Comparison of Methods of Discontinuing Nasal CPAP in Premature Infants <30 Weeks Gestation - a Feasibility Study

The purpose of this study is to determine if among infants <30 weeks gestational age on nasal continuous positive airway pressure (NCPAP), whether discontinuing CPAP after gradual reduction in continuous positive airway pressure (CPAP) pressure leads to successful weaning off CPAP when compared to discontinuing CPAP without weaning pressure.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

66

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Texas
      • Houston, Texas, United States, 77030
        • The University of Texas Health Science Center at Houston

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • All infants < 30 weeks by dates, on NCPAP therapy, on caffeine 10mg/kg daily
  • Meet CPAP stability criteria for ≥ 12hours (CPAP 6 cm water (H2O), FiO2 </=0.25 and stable (to maintain sats 85-95%), Respiratory rate consistently less than 60, Mild to no subcostal/intercostal retractions, No Apnea or bradycardia event that requires bag mask ventilation, Less than 3 apnea/brady/desat episodes in any 1 hour period for previous 6 hours, Tolerated time off CPAP during routine CPAP care (~15 min)

Exclusion Criteria:

  • Major congenital anomalies including congenital heart disease
  • Anomalies that prevent discontinuation of NCPAP
  • Undergoing current evaluation for and/or treatment of sepsis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Discontinue NCPAP after weaning pressures
After randomization, CPAP pressure will be weaned by 1 every 24hours as long as the subjects continue to meet stability criteria after each wean, until CPAP of 4. If after decrease in CPAP pressure, the subject meets CPAP failure criteria pressure will be increased back to the previous level and after stabilization for 24 hours weaning process will be started again. Once the subject meets stability criteria on CPAP of 4, NCPAP will be stopped and subject will be placed on nasal cannula (NC) according to unit guidelines (max 1 Liter flow, 30% FiO2).
After randomization, CPAP pressure will be weaned by 1 every 24hours as long as the subjects continue to meet stability criteria after each wean, until CPAP of 4. If after decrease in CPAP pressure, the subject meets CPAP failure criteria pressure will be increased back to the previous level and after stabilization for 24 hours weaning process will be started again. Once the subject meets stability criteria on CPAP of 4, NCPAP will be stopped and subject will be placed on nasal cannula (NC) according to unit guidelines (max 1 Liter flow, 30% FiO2).
Active Comparator: Discontinue NCPAP without weaning pressures
After randomization, once the subject meets stability criteria, NCPAP will be stopped and subject will be placed on nasal cannula (NC) according to unit guidelines (max 1 Liter flow, 30% FiO2).
After randomization, once the subject meets stability criteria, NCPAP will be stopped and subject will be placed on nasal cannula (NC) according to unit guidelines (max 1 Liter flow, 30% FiO2).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Days on NCPAP or Mechanical Ventilation
Time Frame: from randomization until 28 days post-randomization
Subjects might go on and off NCPAP or mechanical ventilation throughout the 28 days after randomization, and the total number of days will be reported.
from randomization until 28 days post-randomization

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Duration of Endotracheal Ventilation
Time Frame: from randomization until 28 days post-randomization
Subjects might go on and off endotracheal ventilation throughout the 28 days after randomization, and the total number of days will be reported.
from randomization until 28 days post-randomization
Number of Participants Who Failed to Wean Off NCPAP
Time Frame: from randomization until discharge (about 92 days)
from randomization until discharge (about 92 days)
Number of Participants Who Developed Bronchopulmonary Dysplasia
Time Frame: from randomization until discharge (about 92 days)
from randomization until discharge (about 92 days)
Number of Participants Who Developed Necrotizing Enterocolitis
Time Frame: from randomization until discharge (about 92 days)
from randomization until discharge (about 92 days)
Number of Days of Life at Which Infant Starting Taking All Feeds by Mouth
Time Frame: from randomization until discharge (about 92 days)
from randomization until discharge (about 92 days)
Length of Hospital Stay
Time Frame: from admission to hospital until discharge (about 92 days)
from admission to hospital until discharge (about 92 days)
Number of Participants Who Developed Air Leak Disorders
Time Frame: from randomization until discharge (about 92 days)
Air leak disorders include pneumothorax, pneumomediastinum, and pulmonary interstitial emphysema.
from randomization until discharge (about 92 days)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Brittany Duyka, MD, The University of Texas Health Science Center, Houston

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 19, 2017

Primary Completion (Actual)

March 1, 2019

Study Completion (Actual)

March 31, 2019

Study Registration Dates

First Submitted

September 21, 2017

First Submitted That Met QC Criteria

September 21, 2017

First Posted (Actual)

September 25, 2017

Study Record Updates

Last Update Posted (Actual)

March 17, 2020

Last Update Submitted That Met QC Criteria

February 29, 2020

Last Verified

February 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • HSC-MS-17-0334

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Respiratory Distress Syndrome

Clinical Trials on Discontinue NCPAP after weaning pressures

Search Similar Trials