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High-Flow Nasal Cannula Versus Nasal CPAP as Primary Support in Preterm Respiratory Distress Syndrome

3. juli 2026 opdateret af: Kayseri City Hospital

Heated Humidified High-Flow Nasal Cannula Versus Nasal Continuous Positive Airway Pressure as Primary Respiratory Support in Preterm Infants With Respiratory Distress Syndrome: A Randomized Controlled Trial

This single-center randomized controlled trial compared heated humidified high-flow nasal cannula (HHHFNC) with nasal continuous positive airway pressure (nCPAP) as primary noninvasive respiratory support in preterm infants (gestational age 28-34 weeks; birth weight 1000-2000 g) with moderate respiratory distress syndrome. The primary outcome was treatment failure requiring invasive mechanical ventilation within the first 7 days.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Eighty-six infants were randomized 1:1 to HHHFNC (n=43) or nCPAP (n=43). Both arms followed identical surfactant, escalation, and weaning protocols. Outcomes included treatment failure, nasal trauma, sepsis, feeding intolerance, and time to full enteral feeding.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

86

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiesteder

  • Tyrkiet (Türkiye)
    • Kayseri
      • Kayseri, Kayseri, Tyrkiet (Türkiye), 38090
        • Kayseri City Hospital

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

  • Barn

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

Preterm infants admitted to the NICU who fulfilled all of the following were eligible:

  1. Gestational age (GA) 28+0 to 34+6 weeks and/or birth weight 1,000-2,000 g
  2. Clinical and radiological diagnosis of moderate respiratory distress syndrome (RDS)
  3. Silverman-Anderson score (SAS) 4 < SAS < 7
  4. Eligibility for noninvasive ventilatory support

Exclusion Criteria:

  1. Parental refusal of consent
  2. Outborn infants transferred from other centers
  3. Infants who required immediate intubation in the delivery room
  4. Major congenital anomalies, chromosomal disorders, gastrointestinal malformations, or life-threatening congenital cardiac defects
  5. Nasal/pharyngeal anatomical anomalies (choanal atresia, cleft palate/lip)
  6. Moderate-to-severe hypoxic-ischemic encephalopathy (Grade 2-3)
  7. Infants who died unexpectedly shortly after admission without respiratory evaluation

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: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Group 1 Heated humidified high-flow nasal cannula (HHHFNC)
n:43 Vapotherm Precision Flow Hi-VNI; initial flow 5 L/min (range 5-8 L/min), 37°C, 100% humidity; FiO₂ titrated to SpO₂ 91-95%.
Enhed: Group 1 Heated humidified high-flow nasal cannula (HHHFNC)
HHHFNC delivered via the Vapotherm Precision Flow Hi-VNI system; initial flow 5 L/min (range 5-8 L/min), 37°C, 100% humidity; FiO2 titrated to maintain SpO2 91-95%.
Andre navne:
  • Vapotherm Precision Flow Hi-VNI
Aktiv komparator: Group 2 Nasal continuous positive airway pressure (nCPAP)
n:43 nCPAP via ventilator-driven system; pressure 5-8 cmH2O; FiO2 titrated to SpO2 91-95%.
Enhed: Group 2 Nasal continuous positive airway pressure (nCPAP)
nCPAP delivered via a ventilator-driven system; pressure 5-8 cmH2O; FiO2 titrated to maintain SpO2 91-95%.
Andre navne:
  • nCPAP

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Participants With Treatment Failure Requiring Invasive Mechanical Ventilation
Tidsramme: First 7 days of life (assessed at 72 hours, Day 5, and Day 7)
Treatment failure defined as the need for invasive mechanical ventilation per pre-specified criteria (FiO2 >=0.60 to maintain SpO2 91-95%; pH <7.20 with PaCO2 >60 mmHg; recurrent or caffeine-refractory apnea; markedly increased work of breathing; or clinical deterioration determined by the attending neonatologist), assessed at 72 hours, Day 5, and Day 7 of life.
First 7 days of life (assessed at 72 hours, Day 5, and Day 7)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Participants With Nasal Trauma
Tidsramme: During noninvasive respiratory support (first 7 days of life)
Nasal trauma defined as redness, excoriation, bleeding, or crusting at the nasal septum or nares attributed to the respiratory support interface.
During noninvasive respiratory support (first 7 days of life)
Number of Participants With Proven (Culture-Positive) Late-Onset Sepsis
Tidsramme: From 72 hours of life through hospital discharge, an average of 24 days
Culture-positive late-onset sepsis with onset after 72 hours of life.
From 72 hours of life through hospital discharge, an average of 24 days
Number of Participants With Bronchopulmonary Dysplasia (BPD)
Tidsramme: At 36 weeks postmenstrual age
BPD defined as an oxygen requirement at 36 weeks postmenstrual age.
At 36 weeks postmenstrual age

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Participants With Patent Ductus Arteriosus (PDA) Requiring Treatment
Tidsramme: From randomization through hospital discharge, an average of 24 days
PDA requiring medical or surgical treatment.
From randomization through hospital discharge, an average of 24 days
Number of Participants With Intraventricular Hemorrhage (IVH) of Any Grade
Tidsramme: From randomization through hospital discharge, an average of 24 days
IVH of any grade detected on cranial ultrasound.
From randomization through hospital discharge, an average of 24 days
Number of Participants With Necrotizing Enterocolitis (NEC) of Any Stage
Tidsramme: From randomization through hospital discharge, an average of 24 days
NEC of any stage.
From randomization through hospital discharge, an average of 24 days
Number of Participants With Retinopathy of Prematurity (ROP)
Tidsramme: From randomization through hospital discharge, an average of 24 days
ROP of any stage on ophthalmologic examination.
From randomization through hospital discharge, an average of 24 days
Number of Participants With Periventricular Leukomalacia (PVL)
Tidsramme: From randomization through hospital discharge, an average of 24 days
PVL detected on cranial imaging.
From randomization through hospital discharge, an average of 24 days
Number of Participants With Feeding Intolerance
Tidsramme: From randomization through hospital discharge, an average of 24 days
Feeding intolerance per pre-specified clinical criteria.
From randomization through hospital discharge, an average of 24 days
Days to Full Enteral Feeding
Tidsramme: From birth until full enteral feeding is achieved, an average of 8 days
Number of days from birth to achievement of full enteral feeding (>=120 mL/kg/day).
From birth until full enteral feeding is achieved, an average of 8 days
Duration of Total Parenteral Nutrition (TPN)
Tidsramme: From birth through hospital discharge, an average of 24 days
Total duration of parenteral nutrition, in days.
From birth through hospital discharge, an average of 24 days
Duration of Total Oxygen Support
Tidsramme: From randomization through hospital discharge, an average of 24 days
Total duration of any oxygen support, in days.
From randomization through hospital discharge, an average of 24 days
Number of Participants With All-Cause In-Hospital Mortality
Tidsramme: From randomization through hospital discharge, an average of 24 days
All-cause mortality during hospitalization.
From randomization through hospital discharge, an average of 24 days
Number of Participants With Air Leak Syndrome
Tidsramme: First 7 days of life (respiratory support period)
Air leak syndrome, including pneumothorax.
First 7 days of life (respiratory support period)
Number of Participants With Clinically Significant Apnea
Tidsramme: First 7 days of life (respiratory support period)
Clinically significant apnea episodes.
First 7 days of life (respiratory support period)
Discharge Weight
Tidsramme: At hospital discharge, an average of 24 days after randomization
Body weight at hospital discharge, in grams.
At hospital discharge, an average of 24 days after randomization
Hospital Length of Stay
Tidsramme: From randomization through hospital discharge, an average of 24 days
Total length of hospital stay, in days.
From randomization through hospital discharge, an average of 24 days

Samarbejdspartnere og efterforskere

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

Sponsor

Kayseri City Hospital

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 (Faktiske)

1. juni 2020

Primær færdiggørelse (Faktiske)

1. maj 2022

Studieafslutning (Faktiske)

1. maj 2022

Datoer for studieregistrering

Først indsendt

16. juni 2026

Først indsendt, der opfyldte QC-kriterier

3. juli 2026

Først opslået (Faktiske)

9. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

9. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. juli 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Ethics C.D.No:141(Kayseri CH)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

The data that support the findings of this study are not publicly available due to privacy and ethical restrictions but are available from the corresponding author upon reasonable request.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Studerer et amerikansk FDA-reguleret enhedsprodukt

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Kliniske forsøg med For tidlig fødsel

Kliniske forsøg med Group 1 Heated humidified high-flow nasal cannula (HHHFNC)

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Sponsorer og samarbejdspartnere

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Betingelser

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Placeringer

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