- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06373289
Target Oxygen Ranges in Infants With Pulmonary Hypertension (TORPH)
Target Oxygen Saturation Ranges in Infants With Bronchopulmonary Dysplasia Associated Pulmonary Hypertension
Study Overview
Status
Conditions
Detailed Description
Infants born between 22.0 to 31.6 weeks' gestational age with bronchopulmonary dysplasia associated pulmonary hypertension, are receiving supplemental oxygen, and have prethreshold retinopathy of prematurity in at least one eye or have mature retinas will be randomized to SpO2 targets of either (1) 92-95% (control) or (2) 95-98% (intervention).
Using a cross over design with a 1:1 parallel allocation of infants randomized using a stratified permuted block design. Following 2 weeks of exposure A, infants will cross over to exposure B for 2 weeks with a 1-week washout period. Bedside providers will follow pre-specified algorithms to maintain oxygen targets during the randomization period. Reports of oxygen saturation performance will also be provided to bedside providers through oxygen saturation histograms.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Samuel Gentle, MD
- Phone Number: 205-541-2247
- Email: samjgentle@gmail.com
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Between 22w 0/7d and 31w 6/7d gestation at birth
- Diagnosed with echocardiographic pulmonary hypertension (1) >20% flow of blood across the PDA from the pulmonary to arterial circulation, (2) end-systolic flattening of the interventricular septum (eccentricity index >1.3), or (3) right ventricular pressure estimates ≥ 35 mm Hg
- Receiving supplemental oxygen
- Have prethreshold retinopathy of prematurity in at least one eye or have mature retinas
Exclusion Criteria:
- Major congenital anomalies
Study Plan
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 |
---|---|
Active Comparator: Oxygen saturation target 92-95%
At UAB oxygen saturation targeting is achieved using systematic oxygen saturation histogram monitoring every 3-4 hours by nurse, respiratory therapists, and physicians.
Upon randomization to this arm, infants oxygen saturation alarm limits will be adjusted to 92-95% after which an FiO2 modification algorithm will be employed to maintain targets.
Daily compliance reports will be generated to ensure oxygen saturation achievement corresponds with oxygen saturation targets.
Infants will be exposed for a 2 week period after which they will crossover to the alternative oxygen saturation target with a 1 week washout period in between targets.
|
The intervention will be a cross over exposure to the lower oxygen saturation target.
|
Active Comparator: Oxygen saturation target 95-98%
At UAB oxygen saturation targeting is achieved using systematic oxygen saturation histogram monitoring every 3-4 hours by nurse, respiratory therapists, and physicians.
Upon randomization to this arm, infants oxygen saturation alarm limits will be adjusted to 95-98% after which an FiO2 modification algorithm will be employed to maintain targets.
Daily compliance reports will be generated to ensure oxygen saturation achievement corresponds with oxygen saturation targets.
Infants will be exposed for a 2 week period after which they will crossover to the alternative oxygen saturation target with a 1 week washout period in between targets.
|
The intervention will be a cross over exposure to the higher oxygen saturation target.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Intermittent hypoxemia event duration
Time Frame: From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
The average duration of time (in seconds) an infant's oxygen saturation decrease below 80%.
|
From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Echocardiographic shunting
Time Frame: through study completion, 5 weeksFrom date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
>20% flow of blood across the PDA from the pulmonary to arterial circulation
|
through study completion, 5 weeksFrom date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Echocardiographic interventricular septal flattening
Time Frame: From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
End-systolic flattening of the interventricular septum (eccentricity index >1.3)
|
From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Echocardiographic tricuspid regurgitation
Time Frame: From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Right ventricular pressure estimates
|
From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Intermittent hypoxemia frequency
Time Frame: From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Number of daily events during which an infant's oxygen saturation decreases below 80%
|
From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Cumulative hypoxemia
Time Frame: From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Daily duration during which an infant's oxygen saturation is <80%
|
From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Brain natriuretic peptide
Time Frame: From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
A polypeptide released from the cardiac ventricles indicative of right heart strain
|
From date of randomization until 5 weeks have elapsed or date of discharge, whichever came first
|
Collaborators and Investigators
Investigators
- Principal Investigator: Samuel Gentle, University of Alabama at Birmingham
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 000539476
- 1K23HD113837-01A1 (Other Identifier: NICHD (pending))
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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