- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04409665
The Use of Sedation Drugs in the Procedure of Administering Surfactant Without Intubation (LISA/MIST) (LISA KGS)
January 16, 2022 updated by: PAWEL KRAJEWSKI, MD, Medical University of Warsaw
The Use of Sedation Drugs in the Procedure of Administering Surfactant Without Intubation (LISA/MIST): a Randomized Study Comparing Intravenous Ketamine With Sublingual 30% Glucose
The purpose of this study is to evaluate the efficacy and impact of intravenous ketamine or sublingual 30% glucose as sedation drugs used in preterm premature babies during the LISA procedure.
The second goal is to compare the frequency of complications during LISA with both premedication regimens.
Study Overview
Status
Recruiting
Intervention / Treatment
Detailed Description
All infants fulfilling the inclusion criteria during the 12 months recruitment window will potentially be enrolled in this randomized controlled trial of LISA premedication.
Written informed consent will be acquired from parents or legal guardians.
After the consent, infants needing the LISA will receive premedication as follows: caffeine citrate according to the clinical routine at study site, and randomly, either ketamine or sublingual glucose 30%.
This study is a pilot study and 60 patients that will be randomized 1:1.
Ketamine will be given in slow intravenous injection over 60 seconds.
Glucose 30% will be given sublingually in the volume of 1 mL.
After two minutes (from the end of administration of the study drug or reference drug), laryngoscopy will be started.
To assess the effectiveness of both types of sedation, patients will be assessed using two pain assessment scales - the COMFORT scale and the FANS scale.
10 minutes before the procedure, the first assessment in the COMFORT and FANS scales will take place.
The next assessment on both scales will take place during the procedure.
Study Type
Interventional
Enrollment (Anticipated)
60
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Tomasz Piotr Pomianek, MD
- Phone Number: +48 502536300
- Email: tomek.pomianek@gmail.com
Study Contact Backup
- Name: Paweł Krajewski, MD, PhD
Study Locations
-
-
Mazowieckie
-
Warsaw, Mazowieckie, Poland, 02-015
- Recruiting
- Uniwersyteckie Centrum Zdrowia Kobiety Noworodka
-
Contact:
- Tomasz Pomianek, MD
- Phone Number: +48 502536300
- Email: tomek.pomianek@gmail.com
-
Contact:
- Paweł Krajewski, PhD, MD
- Email: pawelkrajewski@outlook.com
-
-
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 minute to 4 months (Child)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Infant with established Respiratory Distress Syndrome (RDS) or at risk for RDS
- Gestational age 28 0/7 - 32 6/7 weeks
- Non-invasive respiratory support with nasal CPAP (incl. BiPAP) or NIPPV
- Need for administration of exogenous surfactant
Exclusion Criteria:
- Need for intubation and mechanical ventilation at the Delivery Room
- Infant with clinically significant maxillo-facial, tracheal or pulmonary malformations
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 |
|---|---|
|
Experimental: Ketamine sedated group
30 randomized patients will receive Ketamine 1 mg/kg , I.V. 2 minutes before LISA
|
Patient will be sedated using Ketamine 2 minutes before the LISA procedure.
10 minutes prior the procedure and during the procedure the patient's pain and/or discomfort will be evaluated using COMFORT and FANS scales
|
|
Active Comparator: Glucose sedated group
30 patients will receive Glucose 30% 1 mL, sublingually, 2 minutes before LISA
|
Patient will be sedated using Glucose 2 minutes before the LISA procedure.
10 minutes prior the procedure and during the procedure the patient's pain and/or discomfort will be evaluated using COMFORT and FANS scales
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Assessment of patient sedation
Time Frame: First assessment 10 minutes before procedure, second during the procedure
|
Assessment of patient sedation change before and after LISA using COMFORT scale
|
First assessment 10 minutes before procedure, second during the procedure
|
|
Assessment of patient sedation
Time Frame: First assessment 10 minutes before procedure, second during the procedure
|
Assessment of patient sedation change before and after LISA using FANS scale
|
First assessment 10 minutes before procedure, second during the procedure
|
|
Comparing ketamine and glucose
Time Frame: Comparing the scores through study completion, an average of two years
|
Comparison of the effectiveness of sedation with ketamine and glucose using the FANS scale scores.
The FANS scale ranges from 0 points at minimum to 10 points at maximum.
The higher the score, the lower the sedation.
|
Comparing the scores through study completion, an average of two years
|
|
Comparing ketamine and glucose
Time Frame: Comparing the scores through study completion, an average of two years
|
Comparison of the effectiveness of sedation with ketamine and glucose using the COMFORT scale scores.
The Comfort scale ranges from 8 points at minimum, to 40 at maximum.
The higher the score, the lower the sedation level.
|
Comparing the scores through study completion, an average of two years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Frequency of complications
Time Frame: During the procedure
|
Monitoring the possible side effects of used drugs
|
During the procedure
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Paweł Krajewski, MD, PhD, Medical University of Warsaw
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
- Kurepa D, Perveen S, Lipener Y, Kakkilaya V. The use of less invasive surfactant administration (LISA) in the United States with review of the literature. J Perinatol. 2019 Mar;39(3):426-432. doi: 10.1038/s41372-018-0302-9. Epub 2019 Jan 11.
- McPherson C, Grunau RE. Neonatal pain control and neurologic effects of anesthetics and sedatives in preterm infants. Clin Perinatol. 2014 Mar;41(1):209-27. doi: 10.1016/j.clp.2013.10.002. Epub 2013 Dec 17.
- Bourgoin L, Caeymaex L, Decobert F, Jung C, Danan C, Durrmeyer X. Administering atropine and ketamine before less invasive surfactant administration resulted in low pain scores in a prospective study of premature neonates. Acta Paediatr. 2018 Jul;107(7):1184-1190. doi: 10.1111/apa.14317. Epub 2018 Apr 16.
- Dekker J, Lopriore E, Rijken M, Rijntjes-Jacobs E, Smits-Wintjens V, Te Pas A. Sedation during Minimal Invasive Surfactant Therapy in Preterm Infants. Neonatology. 2016;109(4):308-13. doi: 10.1159/000443823. Epub 2016 Feb 24.
- McPherson C, Inder T. Perinatal and neonatal use of sedation and analgesia. Semin Fetal Neonatal Med. 2017 Oct;22(5):314-320. doi: 10.1016/j.siny.2017.07.007. Epub 2017 Jul 19.
- Allegaert K, van den Anker JN. Neonatal pain management: still in search for the Holy Grail. Int J Clin Pharmacol Ther. 2016 Jul;54(7):514-23. doi: 10.5414/CP202561.
- Fernandez C, Boix H, Camba F, Comunas JJ, Castillo F. Less Invasive Surfactant Administration in Spain: A Survey Regarding Its Practice, the Target Population, and Premedication Use. Am J Perinatol. 2020 Feb;37(3):277-280. doi: 10.1055/s-0039-1678534. Epub 2019 Feb 4.
- Barrington K. Premedication for endotracheal intubation in the newborn infant. Paediatr Child Health. 2011 Mar;16(3):159-71. doi: 10.1093/pch/16.3.159.
- Milesi C, Cambonie G, Jacquot A, Barbotte E, Mesnage R, Masson F, Pidoux O, Ferragu F, Thevenot P, Mariette JB, Picaud JC. Validation of a neonatal pain scale adapted to the new practices in caring for preterm newborns. Arch Dis Child Fetal Neonatal Ed. 2010 Jul;95(4):F263-6. doi: 10.1136/adc.2008.144758. Epub 2009 Feb 16.
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)
January 1, 2020
Primary Completion (Anticipated)
March 31, 2022
Study Completion (Anticipated)
April 30, 2022
Study Registration Dates
First Submitted
May 20, 2020
First Submitted That Met QC Criteria
May 26, 2020
First Posted (Actual)
June 1, 2020
Study Record Updates
Last Update Posted (Actual)
January 19, 2022
Last Update Submitted That Met QC Criteria
January 16, 2022
Last Verified
January 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Respiration Disorders
- Lung Diseases
- Infant, Newborn, Diseases
- Infant, Premature, Diseases
- Respiratory Distress Syndrome
- Respiratory Distress Syndrome, Newborn
- Hyaline Membrane Disease
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Dissociative
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Excitatory Amino Acid Antagonists
- Excitatory Amino Acid Agents
- Ketamine
Other Study ID Numbers
- LISA KGS TRIAL 2020
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Yes
IPD Plan Description
All of the individual participant data collected during the trial will be available, after de-identification.
The study protocol will also be available.
These documents will be accessible to anyone who provides a methodologically sound proposal immediately following publication with no end date.
IPD Sharing Time Frame
Immediately following publication.
No end date.
IPD Sharing Access Criteria
Anyone who provides a methodologically sound proposal.
IPD Sharing Supporting Information Type
- Study Protocol
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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