Study of the Effects of CPAP and HHHFNC on Diaphragmatic Dimensions in Preterm Infants
Comparative Study of the Effects of Continuous Positive Airway Pressure and Heated, Humidified High Flow Nasal Cannula on Diaphragmatic Dimensions in Preterm Infants
調査の概要
状態
詳細な説明
Preterm infants will be recruited consecutively from NICU of Mansoura University Children's Hospital. They will be randomized in two groups; one group will start on nasal CPAP (Fisher & Paykel Healthcare, Auckland, New Z ealand) (Pressure 5 cmH2O) for 60 minutes and then will be switched to HHHFNC (Fisher & Paykel Healthcare, Auckland, New Z ealand) (flow of 4 l/m) for another 60 minutes. The other group will start on HHHFNC and then switched to nasal CPAP.
After the 2 h study period (2×60 minutes epochs) further respiratory support will be at the discretion of the clinical team.
Ultrasonographic assessment of diaphragmatic dimensions and excursion will be analyzed in different respiratory cycles and the average of 3 cycles will be calculated at the end of the 60 minutes periods on nasal CPAP and HHHFNC.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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-
Dakahlia
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Mansoura、Dakahlia、エジプト、35516
- Neonatal Intensive Care Unit, Mansoura University Children Hospital
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Mansoura、Dakahlia、エジプト、35516
- NICU, Mansoura University Children's Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Preterm infants < 37 weeks.
- Stable on nasal continuous positive airway pressure (CPAP) for at least 24 hours.
- On less than 35% oxygen.
Exclusion Criteria:
- Congenital and acquired problems of the gastrointestinal tract as necrotizing enterocolitis, esophageal perforation and tracheoesophageal fistula.
- Phrenic nerve injury and/or diaphragm paralysis
- Congenital/acquired neurological deficit and/or seizures
- Hemodynamic instability
- Congenital heart disease (including symptomatic patent ductus arteriosus)
- Undergoing treatment for sepsis or pneumonia.
- Use of muscle relaxants, narcotic analgesics, or gastric motility agents.
- Congenital anomalies of respiratory tract.
- Infants requiring more than 35% oxygen.
- Infants with facial anomalies.
- Infants with pneumothorax and/or pneumomediatinum.
- Infants in the immediate postoperative period.
- Infants with significant gastric residues and vomiting.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:クロスオーバー割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
アクティブコンパレータ:CPAP first
Infant will be given nasal CPAP for 60 minutes and then put on HHHFNC for another 60 minutes.
Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of the 60 minute periods on nasal CPAP and HHHFNC.
After the 2 h study period (2×60 minutes epochs) further respiratory support will be at the discretion of the clinical team
|
Infants will start on nasal CPAP for 60 minutes and then switched to HHHFNC for anther 60 minutes.
Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of each 60 minute epochs.
|
アクティブコンパレータ:HHHFNC first
Infant will be given HHHFNC for 60 minutes and then switched to nasal CPAP for another 30 minutes.
Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of the 60 minute periods on HHHFNC and nasal CPAP.
After the 2 h study period (2×60 minutes epochs) further respiratory support will be at the discretion of the clinical team
|
Infants will start on HHHFNC for 60 minutes and then switched to nasal CPAP for anther 60 minutes.
Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of each 60 minute epochs.
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Diaphragmatic dimensions (inspiratory diaphragmatic thickness, expiratory diaphragmatic thickness and delta diaphragmatic thickness)
時間枠:at the end of each 60 minutes epoch on nasal CPAP
|
Ultrasonographic assessment of (inspiratory diaphragmatic thickness, expiratory diaphragmatic thickness and delta diaphragmatic thickness will be assessed at the end of each 60 minutes epoch on nasal CPAP.
Diaphragm thickness will be measured as the perpendicular distance between the pleural and peritoneal reflections.
All measurements will be performed during quiet breathing.
Several respiratory cycles will be recorded, and measurements will be averaged from at least three different cycles.
|
at the end of each 60 minutes epoch on nasal CPAP
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Right and left diaphragmatic excursion
時間枠:at the end of each 60 minute epoch on CPAP
|
Ultrasonographic assessment of right and left diaphragmatic excursion will be assessed at the end of each 60 minutes epoch on nasal CPAP.
The displacements of the liver and spleen will be monitored in real-time.
Using M-mode ultrasonography, with the probe fixed on the chest wall during respiration, ultrasonographic image of will be frozen and a mark for measurement will be placed on the image at the location of the most caudal margin of the liver or spleen at the end of expiration, and a second mark will be placed on the new location of the most caudal margin of the liver or spleen at the end of inspiration.
The distance between the two marks will be then measured and defined as the displacement of the liver or the spleen (right or left diaphragmatic excursion).
Several respiratory cycles will be recorded, and measurements will be averaged from at least three different cycles.
|
at the end of each 60 minute epoch on CPAP
|
Diaphragmatic dimensions (inspiratory diaphragmatic thickness, expiratory diaphragmatic thickness and delta diaphragmatic thickness)
時間枠:at the end of each 60 minutes epochs on HHHNC
|
Ultrasonographic assessment of (inspiratory diaphragmatic thickness, expiratory diaphragmatic thickness and delta diaphragmatic thickness will be assessed at the end of each 60 minutes epoch on HHHFNC.
Diaphragm thickness will be measured as the perpendicular distance between the pleural and peritoneal reflections.
All measurements will be performed during quiet breathing.
Several respiratory cycles will be recorded, and measurements will be averaged from at least three different cycles.
|
at the end of each 60 minutes epochs on HHHNC
|
Right and left diaphragmatic excursion
時間枠:at the end of each 60 minutes epochs on HHHNC
|
Ultrasonographic assessment of right and left diaphragmatic excursion will be assessed at the end of each 60 minutes epoch on HHHFNC.
The displacements of the liver and spleen will be monitored in real-time.
Using M-mode ultrasonography, with the probe fixed on the chest wall during respiration, ultrasonographic image of will be frozen and a mark for measurement will be placed on the image at the location of the most caudal margin of the liver or spleen at the end of expiration, and a second mark will be placed on the new location of the most caudal margin of the liver or spleen at the end of inspiration.
The distance between the two marks will be then measured and defined as the displacement of the liver or the spleen (right or left diaphragmatic excursion).
Several respiratory cycles will be recorded, and measurements will be averaged from at least three different cycles.
|
at the end of each 60 minutes epochs on HHHNC
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Respiratory rate
時間枠:At the end of each 60 minutes epochs on CPAP and HHHFNC
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Respiratory rate will be assessed at the end of each 60 minutes epoch on CPAP or HHHFNC
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At the end of each 60 minutes epochs on CPAP and HHHFNC
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Heart rate
時間枠:At the end of each 60 minutes epochs on CPAP and HHHFNC
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Heart rate will be assessed at the end of each 60 minutes epoch on CPAP or HHHFNC
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At the end of each 60 minutes epochs on CPAP and HHHFNC
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Spo2
時間枠:At the end of each 60 minutes epochs on CPAP and HHHFNC
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Oxygen saturation by pulse oximetry (SpO2) will be assessed at the end of each 60 minutes epoch on CPAP or HHHFNC
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At the end of each 60 minutes epochs on CPAP and HHHFNC
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Number of apneas
時間枠:during the 60 minutes epochs on CPAP and HHHFNC
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Number of apneas will be recorded during the 60 minutes epoch on CPAP or HHHFNC
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during the 60 minutes epochs on CPAP and HHHFNC
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協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- MS 874
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CPAP first (Fisher & Paykel Healthcare)の臨床試験
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Catholic University of the Sacred HeartFisher and Paykel Healthcare完了
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NHS Greater Glasgow and ClydeFisher and Paykel Healthcare; LINET募集