Comparison of Infusion Paracetamol Protocols in PDA

July 9, 2020 updated by: Ufuk Cakir, Ankara University

Comparison of The Effect of Continuous and Standard Intermittent Boluses Paracetamol Infusion on Patent Ductus Arteriosus

The aim of this study was to evaluate the effect of paracetamol on patent ductus arteriosus (PDA) closure and clinical outcomes in preterm infants when used as standard intermittent bolus and continuous intravenous (IV) infusion. Preterm neonates with birth weight (BW) ≤1500 g and gestational age (GA) ≤32 weeks were included in this study. During the study period, IV paracetamol therapy was given to all infants with hemodynamically significant patent ductus arteriosus (hsPDA). The patients were divided into the standard IV intermittent bolus infusion group and the continuous IV infusion group.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Demographic and clinical features Perinatal variables were recorded for all infants, including GA, BW, sex, APGAR scores (at 1 and 5 minutes), prenatal steroids, pre- and post-treatment alanine aminotransferase (ALT)/aspartate aminotransferase (AST), second and third courses of paracetamol, PDA ligation, clinical variables including respiratory distress syndrome (RDS), IVH (grade ≥3), NEC (grade≥2), moderate or severe BPD, ROP requiring laser therapy, early-onset neonatal sepsis (EOS), late-onset sepsis (LOS), duration of non-invasive ventilation (NIV), mechanical ventilation (MV) and oxygen (O2) supplementation, day of full enteral feeding achievement, length of hospital stay, and mortality.

Sepsis with onset at ≤72 hours was defined as EOS and at >72 hours as LOS in infants hospitalized in the NICU. RDS was defined as the need for surfactant administration [5]. IVH was diagnosed by cranial ultrasound in the first 7 days of life (intraparenchymal hemorrhage + IVH, large IVH). NEC diagnosis and staging were implemented by using Bell's criteria. Neonates that received positive pressure or ≥30% oxygen without pressure after a postmenstrual age of 36 weeks were diagnosed as having moderate or severe BPD [8]. ROP screening was done by ophthalmologists according to the International Classification of Retinopathy of Prematurity Revisited [9].

Hemodynamically Significant Patent Ductus Arteriosus All neonates underwent Doppler echocardiography (ECHO) at postnatal 72 hours. Diagnosis of hsPDA was based on clinical and ECHO features [10]. ECHO evaluation was repeated at regular intervals. IV paracetamol was used as primary rescue therapy for hsDPA. If hsPDA persisted despite 3 courses of paracetamol therapy, surgical ligation was performed. The non-hsPDA group comprised non-hsPDA preterm infants selected using the same exclusion criteria. Infants with non-hsPDA were excluded from the study.

Continuous and Standard Intermittent Bolus Infusion of Paracetamol IV paracetamol therapy was delivered as primary rescue pharmacological treatment to all neonates who had hsPDA during the study period. Standard IV intermittent bolus paracetamol therapy was administered in the form of 15 mg/kg doses as 1-hour infusions every 6 hours for 5 days, while continuous IV paracetamol infusion therapy was administered as a 60 mg/kg/day dose continuously for 5 days (Parol, Atabay Ilac Kimya San., Istanbul, Turkey). ALT and AST levels were analyzed before and after treatment . Infants received standard IV intermittent bolus paracetamol between January 1 and April 31, 2018, and continuous IV infusion paracetamol between May 1 - August 31, 2018 for hsPDA medical treatment. Therefore, eligible infants were divided into two groups as the standard IV intermittent bolus infusion group and the continuous IV infusion group.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
138

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

  • Turkey
      • Ankara, Turkey, 06130
        • Ufuk Cakir

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

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

No older than 1 month (Child)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

Preterm preterms with birth weight (BW) ≤1500 g and gestational age (GA) ≤32 weeks will be included in the study.

Description

Inclusion Criteria:

birth weight (BW) ≤1500 g and gestational age (GA) ≤32 weeks at birth

Exclusion Criteria:

birth weight (BW) >1500 g and gestational age (GA) >32 weeks at birth

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

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
standard IV intermittent bolus infusion group
Drug: Paracetamol Infusion
Continuous and Standard Intermittent Boluses Paracetamol Infusion
continuousIV intermittent bolus infusion group
Drug: Paracetamol Infusion
Continuous and Standard Intermittent Boluses Paracetamol Infusion

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Patent Ductus Arteriosus
Time Frame: 6 months
PDA-related morbidities, multiple paracetamol courses, and PDA ligation
6 months

Collaborators and Investigators

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

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ankara University

Publications and helpful links

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General Publications

Study record dates

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Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 1, 2019

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 1, 2019

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
January 6, 2020

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 9, 2020

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 9, 2020

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 14, 2020

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 14, 2020

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 9, 2020

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2020

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 113/2019

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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.

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