Patient Comfort During High Flow Nasal Cannula Versus Nasal Continuous Airway Pressure (CPAP)

June 23, 2017 updated by: University Hospital of North Norway

Patient Comfort During High Flow Nasal Cannula (HFNC)Versus Nasal Continuous Airway Pressure (CPAP): a Cross Over Randomised Trial

Preterm children are at increased risk for developing lung disease due to immature lungs. Non-invasive ventilation (NIV) support is increasingly used as treatment. Nasal continuous positive airway pressure (nCPAP) is the most common NIV-mode. Recently, high flow nasal cannulas (HFNC) have become an alternative NIV-mode. Both nCPAP and HFNC provide increased pressure in the airways aiming to keep the lungs open. With nCPAP it is common to use short binasal prongs that fill the nostrils completely and are pressed tightly over the nose. With HFNC oxygen/air is administered via two small, thin cannulas located just inside the nostrils, but the nostrils are not blocked.

The aim of this study is to compare patient comfort in premature infants treated with nCPAP and HFNC. The investigators hypothesis is that HFNC increases patient comfort.

The study is a randomized cross over study (2 x 24 hours). Children eligible for inclusion should be born before 34 weeks of gestation and have moderate respiratory distress, thus be "in need" of nCPAP. During the study period (48 hours) the investigators will consider how the child tolerates treatment with nCPAP versus HFNC. Primary outcome is patient comfort assessed with the EDIN-score (Neonatal pain and comfort score). Secondary outcomes are stress hormone response (cortisol in saliva), surrounding noise and parental satisfaction. The child's breathing pattern will be carefully monitored. The study involves no extra painful investigations.

The investigators plan to recruit 20 patients.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

24

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

  • Norway
      • Tromsø, Norway, N-9038
        • University Hospital of North Norway

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

5 months to 7 months (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Preterm infants admitted to the NICU at University Hospital of North Norway, Tromsoe, Norway (single center study)

    • Gestational age (GA) < 34 weeks
    • Corrected age < 34 weeks
    • Receiving nasal CPAP for respiratory distress
    • Respiratory "stable": FiO2 < 30%, pCO2 < 8,5 kPa and pH > 7.25.
  • GA < 29 weeks: Respiratory "stable" over last 72 h.
  • GA 29-33 weeks: Respiratory "stable" over last 24 h.

Exclusion Criteria:

  1. Congenital anomalies
  2. Ongoing treatment for hypoglycemia or infection
  3. Other intercurrent disease requiring frequent blood sampling

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: HFNC
High flow nasal cannula
Device: Respiratory support HFNC
In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP
Other Names:
  • HFNC; Fisher and Paykel
Device: Respiratory support NCPAP
In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP
Other Names:
  • NCPAP: Infant Flow (CareFusion)
Active Comparator: nCPAP
Nasal CPAP
Device: Respiratory support HFNC
In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP
Other Names:
  • HFNC; Fisher and Paykel
Device: Respiratory support NCPAP
In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP
Other Names:
  • NCPAP: Infant Flow (CareFusion)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patient comfort (EDIN score)
Time Frame: 48 h (CPAP 24 h and HFNC 24 h); cumulative EDIN score for each 24 epoch is calculated and a change between the two interventions are assessed
EDIN score (neonatal pain and comfort score) is a validated scoring system to assess pain and comfort in term and preterm infants. The cumulative EDIN score, based on three evaluations/24 h, is recorded for each 24 h epoch with HFNC or CPAP, respectively. The change in EDIN score between the two 24 h epochs are assessed.
48 h (CPAP 24 h and HFNC 24 h); cumulative EDIN score for each 24 epoch is calculated and a change between the two interventions are assessed

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Noise
Time Frame: Measured at 10 AM and 10 PM over 48 h (4 measurements)
Surrounding noise (dB)is measured twice daily during the 2 x 24 (48) h study period; twice during CPAP and twice during HFNC.
Measured at 10 AM and 10 PM over 48 h (4 measurements)
Parental satisfaction
Time Frame: Three questions answered after 24 h and 48 h
3 questions related to parental satisfaction are asked by the end of each 24 h epoch with either CPAP or HFNC.
Three questions answered after 24 h and 48 h
Stress hormone response (salivary cortisol)
Time Frame: Measured at 10 AM and 10 PM over 48 h (4 measurements)
Salivary cortisol is used as a marker of stress hormone response. Salivary cortisol is collected twice (10 AM and 10 PM) for every 24 h epoch; a total of 4 measurements.
Measured at 10 AM and 10 PM over 48 h (4 measurements)

Collaborators and Investigators

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

Sponsor

University Hospital of North Norway

Investigators

  • Principal Investigator: Claus Klingenberg, MD, PhD, University Hospital of North Norway, Tromsø, Norway

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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

February 1, 2012

Primary Completion (Actual)

May 1, 2013

Study Completion (Actual)

May 1, 2013

Study Registration Dates

First Submitted

January 2, 2012

First Submitted That Met QC Criteria

January 31, 2012

First Posted (Estimate)

February 3, 2012

Study Record Updates

Last Update Posted (Actual)

June 26, 2017

Last Update Submitted That Met QC Criteria

June 23, 2017

Last Verified

June 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2011-2019 REK NORD

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, Newborn

Clinical Trials on Respiratory support HFNC

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Uzbekistan

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

3
Subscribe