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Feasibility and Acceptability Followed by Effectiveness of bCPAP for Treatment of Bangladeshi Children With Severe Pneumonia (Child-bCPAP)

2022年2月3日 更新者：International Centre for Diarrhoeal Disease Research, Bangladesh

Feasibility and Acceptability Followed by Effectiveness of Bubble Continuous Positive Airway Pressure for Treatment of Bangladeshi Children With Severe Pneumonia

Background: Feasibility and acceptability of bubble continuous positive airway pressure (CPAP) were not evaluated in childhood severe pneumonia in developing countries at a larger scale.

Objective:

  1. To describe prevailing structural and functional conditions and other operational challenges in nontertiary hospitals in Bangladesh that would need to be addressed in order to introduce bubble CPAP as part of the management of children with severe pneumonia enabling a successful interventional trial.
  2. To develop and test bubble CPAP training materials of relevance to clinical staff providing care for children with severe pneumonia in district general hospitals.
  3. To determine the prevalence of hypoxaemia among hospitalised children with severe pneumonia in non-tertiary/district hospitals, current practices with regard to management and clinical outcome, to support power calculations of a future interventional trial of bubble CPAP for children with severe pneumonia.
  4. To document the early experience, particularly the feasibility and acceptability of introducing bubble CPAP in selected non-tertiary/district hospitals.

Methodology:

Feasibility/demonstration phase will be done as an internal pilot in 2 hospitals. Current treatment practice, facilities, and operational challenges will be evaluated for the introduction, clinical use and maintenance of bubble CPAP.

Outcome:

  1. To describe the structural and functional conditions and operational challenges that may influence the introduction of bubble CPAP.
  2. To have bubble CPAP training materials that can be delivered cheaply and repeatedly to a level of comprehension of staff providing care to children with pneumonia in district general hospitals in Bangladesh.
  3. A quantitative analysis of the incidence of hypoxaemia among hospitalised children with severe pneumonia, current management practices and clinical outcomes.
  4. A qualitative assessment of the feasibility of introducing bubble CPAP.

Number of children to be enrolled: 20 children in 2 hospitals as an internal pilot (i.e. 10 in each hospital)

Main inclusion criteria: Age between 2 months and 24 months with severe pneumonia and hypoxemia and guardian/parent gives written informed consent to participate in the study.

Statistical Analysis: For feasibility and acceptability study, a descriptive analysis will be performed.

Study duration: 44 months

調査の概要

状態

完了

条件

介入・治療

研究の種類

観察的

入学 (実際)

20

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

  • バングラデシュ
      • Dhaka、バングラデシュ、1212
        • Institute of Child and Mother Health
      • Kustia、バングラデシュ
        • 250 Bedded General Hospital

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

2ヶ月～2年 (子)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

Children aged 2-24 months having hypoxaemia in pneumonia (Pneumonia defined by WHO criteria)

説明

INCLUSION CRITERIA

  • Staff:

    • Staff (medical and nursing) employed at the two selected hospitals with duties that include care of children with pneumonia
    • Staff who agree to participate and give written informed consent

  • Children for assessment of hypoxaemia in pneumonia and outcomes:

    • Age between 2 - 24 months
    • Attend one of the two study hospitals for the assessment of pneumonia by hospital clinician.
    • Pneumonia defined by WHO criteria

  • Children receiving bubble CPAP:

    • Age between 2 - 24 months.
    • Diagnosis of pneumonia by a hospital clinician together with hypoxaemia (SpO2<90%).
    • Parent/guardian gives informed consent to participate in the study

EXCLUSION CRITERIA

  • Hospital staff:

    o There will be no exclusion criteria

  • Children for assessment of hypoxaemia in pneumonia and outcomes, and children receiving bubble CPAP:

    • Known congenital heart disease, asthma, pulmonary TB and other chronic respiratory disorders

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

コホートと介入

グループ/コホート
介入・治療
bubble CPAP arm

Oxygen will be delivered by Bubble CPAP device, which will have three components:

  1. Continuous gas flow into the circuit: The gas flow rate required to generate CPAP is usually 5-10 L/min.
  2. A nasal interface connecting the child's airway with the circuit: short nasal prongs are generally used to deliver nasal CPAP. They must be carefully fitted to minimize leakage of air (otherwise, CPAP will not be achieved) .
  3. An expiratory arm with the distal end submerged in water to generate end-expiratory pressure: in bubble CPAP, the positive pressure is maintained by placing the far end of the expiratory tubing in water. The pressure is adjusted by altering the depth of the tube under the surface of the water.
デバイス：Bubble CPAP oxygen delivery device

In Bubble CPAP, pressurized oxygen from an oxygen cylinder is delivered to the nasopharynx of the baby. An underwater tube (expiratory arm) that acts as a blow off valve is interposed between the oxygen source and the baby. Adjusting the height of the water column above the exit of the tube can regulate the pressure in the system and the amount of CPAP delivered to the baby. The constant bubbling of gas through the blow off mechanism delivers the bubbling CPAP effect. Oxygen may be delivered by nasal prongs inserted into the nostril of child.

The system has three components:

  1. Continuous gas flow into the circuit: The gas flow rate required to generate CPAP is usually 5-10 L/min.
  2. A nasal interface connecting the child's airway with the circuit:
  3. An expiratory arm with the distal end submerged in water to generate end-expiratory pressure.

The source of oxygen will be either an oxygen concentrator or cylinder, central distribution through pipelines.

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
The structural, functional and operational challenges will be described
時間枠：44 month
Human resources, Supply chain, logistics equipment maintenance, power failure, disconnection of oxygen with local complications will be identified.
44 month
To have bubble CPAP training materials that can be delivered cheaply and repeatedly to a level of comprehension of staff providing care to children with pneumonia in district general hospitals in Bangladesh
時間枠：44 month
The training module, Standard Operating Procedure, treatment algorithm will be provided to the hospital staff. Hands-on training will be done.
44 month
A quantitative analysis of the incidence of hypoxaemia among hospitalised children with severe pneumonia, current management practices and clinical outcomes
時間枠：44 month
Prevalence, management, mortality, referral, discharge, hospital stay, oxygen therapy duration of severe pneumonia cases will be identified.
44 month
Feasibility and acceptability of introducing bubble CPAP
時間枠：44 month
Challenges related to the introduction of bCPAP, enrollment, patient management with follow-up recording, human resources, respiratory support will be identified.
44 month

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

International Centre for Diarrhoeal Disease Research, Bangladesh

協力者

University of Edinburgh
NIHR Global Health Research Unit on Respiratory Health (RESPIRE)
Director General of Health Services, Bangladesh

捜査官

  • 主任研究者：Md. Mohammod J Chisti, PhD、Senior Scientist

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2018年12月1日

一次修了 (実際)

2021年12月31日

研究の完了 (実際)

2021年12月31日

試験登録日

最初に提出

2018年10月16日

QC基準を満たした最初の提出物

2022年2月3日

最初の投稿 (実際)

2022年2月15日

学習記録の更新

投稿された最後の更新 (実際)

2022年2月15日

QC基準を満たした最後の更新が送信されました

2022年2月3日

最終確認日

2021年12月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • PR-18049

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

After the end of the study, data will be analyzed as ter the defined data analysis plan on the protocol. Study results will be shared with other researchers by journal publications, conferences proceedings and dissemination programs

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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