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

23. juni 2017 opdateret af: 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.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

24

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

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

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

5 måneder til 7 måneder (Barn)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

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

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: HFNC
High flow nasal cannula
Enhed: Respiratory support HFNC
In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP
Andre navne:
  • HFNC; Fisher and Paykel
Enhed: Respiratory support NCPAP
In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP
Andre navne:
  • NCPAP: Infant Flow (CareFusion)
Aktiv komparator: nCPAP
Nasal CPAP
Enhed: Respiratory support HFNC
In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP
Andre navne:
  • HFNC; Fisher and Paykel
Enhed: Respiratory support NCPAP
In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP
Andre navne:
  • NCPAP: Infant Flow (CareFusion)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Patient comfort (EDIN score)
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Noise
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University Hospital of North Norway

Efterforskere

  • Ledende efterforsker: Claus Klingenberg, MD, PhD, University Hospital of North Norway, Tromsø, Norway

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. februar 2012

Primær færdiggørelse (Faktiske)

1. maj 2013

Studieafslutning (Faktiske)

1. maj 2013

Datoer for studieregistrering

Først indsendt

2. januar 2012

Først indsendt, der opfyldte QC-kriterier

31. januar 2012

Først opslået (Skøn)

3. februar 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

26. juni 2017

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. juni 2017

Sidst verificeret

1. juni 2013

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2011-2019 REK NORD

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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