Impact of Different Modes of Noninvasive Ventilation on Regional Oximetry and Hemodynamics in Premature Newborn
Impact of Different Modes of Noninvasive Ventilation (NCPAP Versus TrPA) on Regional Cerebral and Splanchnic Oximetry as Measured by Near Infrared Spectroscopy (NIRS) and Hemodynamics Using Echocardiography in Premature Newborns
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Preterm babies under 32 weeks of gestational age usually needs to be supported with breathing machine because of different kinds of problems like lungs immaturity or infection. One type of breathing machine support is called CPAP(Continuous Positive Airway Pressure).This breathing support machine is connected to the nose to help preterm baby breathe. This machine blows air or an air/oxygen mixture through the nose and in to the baby's lung; this helps to keep baby's lungs fully open and makes it easier for the baby to breathe. There are two ways this machine can help the baby breathe - it can either blow the air/oxygen mixture at the same pressure all the time…we call that CPAP, or we can vary the pressure - we call that TrPA(Trigger Pressure Assist). Both methods have been in use in neonatal intensive care units(NICUs) for several years and both methods help with the breathing of babies.
The breathing machine (CPAP) makes the lungs better inflated. This inflation might affect the ability of the heart to push the blood to the organs through the blood vessels. Also we do not know whether there is any difference in the blood flow or oxygen delivery depending whether the baby is on CPAP or TrPA.
We will measure the heart function using Ultrasound (Echocardiography). To measure the efficiency of the flow of the blood through the vessels to the organs we will use Near Infra Red Spectroscopy (NIRS); this involves applying a sensor to the baby's skin - one on the forehead and one on the tummy and connecting the sensors to a machine which can measure the oxygen level in the organ under the skin.
While the baby is on CPAP, we will start monitoring oxygen saturation by applying NIRS sensors to the forehead and the abdomen. After 3 hours we will do echocardiography (ultrasound of the heart)to see any changes that might happen to the heart and blood vessels while the baby is on CPAP. Then, using the same machine, we will change the mode of respiratory support to TrPA. After another three hours, we will do another echocardiography (ultrasound of the heart), then we will stop NIRS monitoring and change the mode of respiratory support back to CPAP.
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
-
-
Manitoba
-
Winnipeg, Manitoba, Canada, R2H 2A6
- St. Boniface General Hospital
-
Winnipeg, Manitoba, Canada, R3A 1S1
- Health Sciences Center
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Inclusion Criteria:
- Preterm infants less than 34 weeks gestational age
- Requirement of CPAP or TrPA as a mode of respiratory support
Exclusion Criteria:
- Lack of parental consent
- Preterm infants more than 34 gestational weeks
- Preterm infants with congenital malformation
- Severe perinatal asphyxia
- Hemodynamically significant patent ductus arteriosus (PDA)
- Pulmonary hypertension
- Septic shock
- Any associated congenital heart diseases other than non-significant PDA or patent foramen ovale (PFO)
- Stage 2 or 3 necrotising enterocolitis (NEC)
- Intraventricular hemorrhage (IVH) grade 3 or 4
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
|
Preterm ≤ 32 weeks GA, on CPAP
Preterm infants less than 32 weeks gestational age requiring CPAP as a mode of respiratory support and admitted in the NICU.While the baby is on CPAP,tissue oxygen saturation monitoring will be started by applying NIRS(Near Infrared Spectroscopy Monitoring) sensors to the forehead and the abdomen.
After 3 hours,echocardiography(including Superior Mesenteric Artery Doppler) will be done while the baby is on CPAP.
Then, using the same machine, the mode of respiratory support will be changed to TrPA.
After another three hours,another echocardiography will be done,then NIRS monitoring will be stopped and the mode of respiratory support will be changed back to CPAP.
|
Measurement of:
Measurement of cerebral and mesenteric regional oxygen saturation(rSO2) trends and data while the baby on CPAP or TrPA modes of noninvasive ventilation.
Autres noms:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change in cardiac output
Délai: Day 3 of life till 2 months of age
|
Targeted neonatal Echocardiography will be done according to the guidelines accepted by the writing group of the American society of echocardiography in collaboration with associations of European pediatric cardiologists The following standard windows will be used:
Measurements:
|
Day 3 of life till 2 months of age
|
|
Changes in Superior Mesenteric Artery and Middle Cerebral Artery Doppler flow.
Délai: Day 3 of life till 2 months of age
|
Day 3 of life till 2 months of age
|
|
|
Cerebral and mesenteric regional tissue oxygenation
Délai: Day 3 of life till 2 months of age
|
Cerebral and mesenteric rSO2 trends and data (obtained by NIRS) will be recorded along with simultaneous pulse oximeter trends and data.
The splanchnic-cerebral oxygenation ratio (SCOR) reflecting the ratio between regional cerebral oxygen saturation(rcSO2) and regional splanchnic oxygen saturation (rsSO2)(rcSO2/rsSO2) will be analyzed.
|
Day 3 of life till 2 months of age
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Directeur d'études: Ganesh Srinivasan, MD, University of Manitoba
- Directeur d'études: Mary S Seshia, MD, University of Manitoba
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies des voies respiratoires
- Troubles respiratoires
- Maladies pulmonaires
- Nourrisson, nouveau-né, maladies
- Complications de grossesse
- Complications du travail obstétrical
- Travail obstétrique, prématuré
- Nourrisson, Prématuré, Maladies
- Naissance prématurée
- Syndrome de détresse respiratoire
- Syndrome de détresse respiratoire, nouveau-né
Autres numéros d'identification d'étude
- B2013: 055
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .