Preservation of Blood in Extremely Preterm Infants (LIM)
A Randomised Controlled Intervention, Multi-centre Study Aiming to Preserve Blood Factors Using Micro-methods to Improve Development in Extremely Preterm Infants - "Less is More"
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Extremely preterm (EPT) infants are subjected to a sample-related withdrawal of whole blood of 50 % of total blood volume during the first 2 postnatal weeks and a transfused volume of 100 % of total blood volume with donor blood during the corresponding time period. The resulting decrease in the proportion of fetal hemoglobin is strongly associated with morbidity outcome, especially broncho-pulmonary dysplasia (BPD), in the EPT infant.
This randomized trial evaluates if a reduction in sample-related blood volume loss by 50% during the first two postnatal weeks leads to a reduced rate of BPD in EPT infants. Half of the included infants will be subjected to clinical blood sampling using micromethods during the first two postnatal weeks whereas blood sampling in the other half of infants will be performed using standard clinical methods.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Lund, Sweden, 221 85
- Neonatal Intensive Care Unit
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- gestational age < 27 weeks at birth
Exclusion Criteria:
- major malformation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Micromethods for blood sample analysis
Blood gases are analysed using 0.045 ml whole blood Levels of C-reactive protein (CRP) are analysed using 0.010 ml whole blood
|
Micromethods in the intervention arm are applied aiming to achieve a mean reduction of 50 % of sampled blood volume during the first two postnatal weeks as compared to standard clinical blood sampling analyses
|
|
No Intervention: Standard clinical methods for blood sample analysis
Blood gases are analysed using 0.3 ml whole blood Levels of CRP are analysed using 0.5 ml whole blood
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Broncho-pulmonary dysplasia
Time Frame: Broncho-pulmonary dysplasia is determined at a postmenstrual age of 36 weeks
|
Requirement of supplemental oxygen as determined by the oxygen challenge test
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Broncho-pulmonary dysplasia is determined at a postmenstrual age of 36 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cerebral intraventricular haemorrhage
Time Frame: Ultrasound at postnatal day 3, 7, 21 and 40 weeks postmenstrual age
|
Stage II, III and IV (Periventricular hemorrhagic infarction)
|
Ultrasound at postnatal day 3, 7, 21 and 40 weeks postmenstrual age
|
|
Necrotizing enterocolitis
Time Frame: From birth until 40 weeks postmenstrual age
|
Stage 2-3, Bells criteria (X-ray + clinical signs)
|
From birth until 40 weeks postmenstrual age
|
|
Blood transfusions
Time Frame: Blood transfusions administered during the first two postnatal weeks
|
Administered blood transfusions (ml/kg)
|
Blood transfusions administered during the first two postnatal weeks
|
|
Fetal Hemoglobin
Time Frame: % of fetal hemoglobin at 7 and 14 postnatal days
|
% of fetal hemoglobin
|
% of fetal hemoglobin at 7 and 14 postnatal days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: David Ley, MD, PhD, Lund University, Lund, Sweden
Publications and helpful links
General Publications
- Hellstrom W, Martinsson T, Morsing E, Granse L, Ley D, Hellstrom A. Low fraction of fetal haemoglobin is associated with retinopathy of prematurity in the very preterm infant. Br J Ophthalmol. 2022 Jul;106(7):970-974. doi: 10.1136/bjophthalmol-2020-318293. Epub 2021 Feb 5.
- Larsson SM, Ulinder T, Rakow A, Vanpee M, Wackernagel D, Savman K, Hansen-Pupp I, Hellstrom A, Ley D, Andersson O. Hyper high haemoglobin content in red blood cells and erythropoietic transitions postnatally in infants of 22 to 26 weeks' gestation: a prospective cohort study. Arch Dis Child Fetal Neonatal Ed. 2023 Nov;108(6):612-616. doi: 10.1136/archdischild-2022-325248. Epub 2023 May 11.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
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
- 2018-00770
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
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