Registry of Preterm Newborns With Severe Pulmonary Hypertension

March 2, 2023 updated by: University of Colorado, Denver

Prospective Multicenter Registry for Preterm Newborns With Severe Pulmonary Hypertension

The purpose of this prospective research registry is to collect data on treatment strategies and outcomes for premature newborns with severe pulmonary hypertension (PH).

Study Overview

Status

Completed

Detailed Description

There is a lack of consensus on the role of inhaled nitric oxide (iNO) therapy and other pulmonary vasodilators for the treatment of severe pulmonary hypertension (PH) in premature newborns (<34 weeks gestation). However, a proper randomized, controlled trial of iNO in premature newborns with severe PH has not been completed. Some practices embrace the American Academy of Pediatrics (AAP) statement that there is no condition for which iNO should be used in the premature newborn, and others selectively treat premature infants with inhaled nitric oxide (iNO) who suffer life threatening hypoxemia due to suprasystemic PH and right-to-left veno-arterial admixture across the arterial duct and/or oval foramen. The number of neonatal intensive care units (NICUs) adopting each of these approaches is currently unknown, but it is possible that the former group is increasing due to administrative pressure to reduce uncompensated off-label iNO use. A prospective registry collection of treatment strategies and outcomes for this subset of premature newborns will help define current treatment strategies and yield important information about safety and efficacy of the different approaches to management, and would inform the debate more effectively than a series of iNO treated infants alone. Data collected includes maternal age, race/ethnicity, pregnancy and delivery complications, prenatal medications, infant characteristics such as Apgar scores, birthweight, congenital anomalies, respiratory status, pharmacologic therapy used for PH and its side effects, and blood gas data. Up to 100 sites in North America will be invited to monitor for appropriate cases.

Study Type

Observational

Enrollment (Actual)

232

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

    • Colorado
      • Aurora, Colorado, United States, 80045
        • University of Colorado

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

1 second to 45 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Premature newborns and their mothers recruited from up to 100 neonatal intensive care units

Description

Inclusion Criteria:

  • Premature newborns 23-34 weeks gestation
  • Echocardiographic evidence showing systemic or suprasystemic levels of PH, or > 5% difference in pre-post ductal saturation if echo is not available.
  • Fraction of inspired oxygen (FiO2) >0.60 in the first 72 hours after birth

Exclusion Criteria:

  • None

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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mortality
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Occurrence of death
From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Cause of death
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
The cause, if death occurred
From birth through hospital discharge or death, whichever occurs first, assessed up to one year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Days Hospitalized
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Total number of days in hospital
From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Number of Days on Ventilation
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Total number of days on mechanical ventilation
From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Classification of Bronchopulmonary Dysplasia (BPD)
Time Frame: At 36 weeks after birth
BPD classification
At 36 weeks after birth
Development of Necrotizing Enterocolitis (NEC)
Time Frame: From birth through surgical repair of NEC, assessed up to one year
Occurrence of surgical repair of NEC
From birth through surgical repair of NEC, assessed up to one year
Development of Early Bacterial Sepsis
Time Frame: From Birth through 3 days of life
Early Occurrence of Bacterial sepsis, e.g. 3 days or less
From Birth through 3 days of life
Development of Late Bacterial Sepsis
Time Frame: From Day 4 of life through hospital discharge or death, whichever occurs first, assessed up to one year
Late Occurrence of Bacterial sepsis, e.g. >3 days
From Day 4 of life through hospital discharge or death, whichever occurs first, assessed up to one year
Intracranial hemorrhage
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Occurrence and severity of intracranial hemorrhage
From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Cystic Periventricular Leukomalacia (PVL)
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Occurrence of PVL
From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Surgery for Retinopathy of Prematurity (ROP)
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Occurrence of surgical repair of ROP
From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Patent Ductus Arteriosus (PDA) Ligation
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Occurrence of surgical repair of PDA
From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Pneumothorax
Time Frame: From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Occurrence of pneumothorax
From birth through hospital discharge or death, whichever occurs first, assessed up to one year
Neurological Exam
Time Frame: The most recent exam immediately prior to discharge or death, whichever occurs first, assessed up to one year
Results of neurological exam: Normal, Abnormal, Suspect
The most recent exam immediately prior to discharge or death, whichever occurs first, assessed up to one year

Collaborators and Investigators

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

Collaborators

Investigators

  • Principal Investigator: John P Kinsella, MD, University of Colorado, Denver

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)

August 1, 2017

Primary Completion (Actual)

July 2, 2022

Study Completion (Actual)

July 2, 2022

Study Registration Dates

First Submitted

September 15, 2017

First Submitted That Met QC Criteria

October 10, 2017

First Posted (Actual)

October 16, 2017

Study Record Updates

Last Update Posted (Estimate)

March 6, 2023

Last Update Submitted That Met QC Criteria

March 2, 2023

Last Verified

March 1, 2023

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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