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- Klinische proef NCT01727609
Speed of Increasing Milk Feeds Trial (SIFT)
A Multi-centre Randomised Controlled Trial of Two Speeds of Daily Increment of Milk Feeding in Very Preterm or Very Low Birth Weight Infants
Survival of preterm infants has increased greatly over the years, so a major aim now is to improve the long term outlook for these babies and to avoid serious complications. The way babies are fed in early life affects short and long-term health and survival.
Because the bowels of preterm infants have not matured, they cannot digest large volumes of milk feeds straight away. Until the gut matures, nutrition is provided by intravenous drip while the amount of milk given is gradually increased over time. Increasing the amount of milk rapidly may increase the risk of gut complications. Increasing the amount of milk given more slowly means that intravenous nutrition is needed for longer; there is an associated risk of infection proportional to the time the intravenous line is present in the bloodstream of these infants. Despite the importance of milk feeding preterm infants, there have been few studies to inform how best to balance these risks, and what the best way to increase feeds in these infants is - this study sets out to address this missing information.
The study will compare two different speeds of milk feed increase, one 'faster' and one 'slower', both within rates currently used in United Kingdom neonatal units. The study aims to find out if either speed of milk feed increase gives better outcomes for the infants. Investigators will measure a variety of outcomes, such as survival without disability, infection, bowel problems, growth and long-term physical and mental development, as well as the impact on families and the National Health Service, including costs.
The study is being led by an established team of researchers who have run similar studies before, and uses an established network of neonatal units that have taken part in previous studies.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Dublin, Ierland, Dublin 2
- National Maternity Hospital, Dublin
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Ashford, Verenigd Koninkrijk, TN24 0LZ
- William Harvey Hospital
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Belfast, Verenigd Koninkrijk, BT12 6BB
- Royal Maternity Hospital, Belfast
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Birmingham, Verenigd Koninkrijk, B9 5SS
- Birmingham Heartlands Hospital
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Birmingham, Verenigd Koninkrijk, B15 2TG
- Birmingham Women's Hospital
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Birmingham, Verenigd Koninkrijk, B18 7QH
- Birmingham City Hospital
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Bradford, Verenigd Koninkrijk, BD9 6RJ
- Bradford Royal Infirmary
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Bristol, Verenigd Koninkrijk, BS10 5NB
- Southmead Hospital
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Bristol, Verenigd Koninkrijk, S2 8EG
- St Michael's Hospital
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Chertsey, Verenigd Koninkrijk, KT16 0PZ
- St Peters Hospital
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Chester, Verenigd Koninkrijk
- Countess of Chester Hospital
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Coventry, Verenigd Koninkrijk, CV2 2DX
- University Hospital Coventry
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Crewe, Verenigd Koninkrijk
- Leighton Hospital
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Derby, Verenigd Koninkrijk, DE22 3NE
- Derbyshire Children's Hospital
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Edinburgh, Verenigd Koninkrijk, EH16 4SA
- Royal Infirmary of Edinburgh
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Exeter, Verenigd Koninkrijk, EX2 5DW
- Royal Devon and Exeter Hospital
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Glasgow, Verenigd Koninkrijk, G31 2ER
- Princess Royal Maternity Hospital, Glasgow
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Glasgow, Verenigd Koninkrijk, G51 4TF
- Southern General Hospital
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Gloucester, Verenigd Koninkrijk
- Gloucestershire Royal Hosptial
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Halifax, Verenigd Koninkrijk, HX3 0PW
- Calderdale Royal Hospital
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Hull, Verenigd Koninkrijk, HU3 2JZ
- Hull Royal Infirmary
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Kettering, Verenigd Koninkrijk
- Kettering General Hospital
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Leeds, Verenigd Koninkrijk, LS9 7TF
- St James's University Hospital
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Leeds, Verenigd Koninkrijk, LS1 3EX
- Leeds General Infirmary
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Leicester, Verenigd Koninkrijk, LE1 5WW
- Leicester Royal Infirmary
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Lincoln, Verenigd Koninkrijk
- Lincoln County Hospital
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London, Verenigd Koninkrijk, SW17 0QT
- St George's Hospital
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Londonderry, Verenigd Koninkrijk, BT47 6SB
- Altnagelvin Area Hospital
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Middlesbrough, Verenigd Koninkrijk, TS4 3BW
- James Cook University Hospital
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Newcastle, Verenigd Koninkrijk, NE1 4LP
- Royal Victoria Infirmary
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Northampton, Verenigd Koninkrijk
- Northampton General Hospital
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Nottingham, Verenigd Koninkrijk
- Nottingham City Hospital
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Nottingham, Verenigd Koninkrijk
- Queen's Medical Centre
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Oxford, Verenigd Koninkrijk, OX3 9DU
- John Radcliffe Hospital
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Plymouth, Verenigd Koninkrijk
- Derriford Hospital
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Portadown, Verenigd Koninkrijk
- Craigavon Area Hospital
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Portsmouth, Verenigd Koninkrijk, PO6 3LY
- Queen Alexandra Hospital, Portsmouth
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Reading, Verenigd Koninkrijk, RG1 5AN
- Royal Berkshire Hospital
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Romford, Verenigd Koninkrijk, RM7 0AG
- Queen's Hospital, Romford
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Sheffield, Verenigd Koninkrijk, S10 2SF
- Jessop Wing, Sheffield
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Shrewsbury, Verenigd Koninkrijk, SY3 8XQ
- Royal Shrewsbury Hospital
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Southampton, Verenigd Koninkrijk, SO16 5YA
- Princess Anne Hospital, Southampton
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Stockton on Tees, Verenigd Koninkrijk, TS19 8PE
- University Hospital of North Tees
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Stoke-on-Trent, Verenigd Koninkrijk, ST4 6QG
- Royal Stoke University Hospital
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Sunderland, Verenigd Koninkrijk, SR4 7TP
- Sunderland Royal Hospital
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Sutton-in-Ashfield, Verenigd Koninkrijk
- King's Mill Hospital
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Swansea, Verenigd Koninkrijk, SA2 8QA
- Singleton Hospital
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Swindon, Verenigd Koninkrijk, SN3 6BB
- Great Western Hospital, Swindon
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Thornton Heath, Verenigd Koninkrijk, CR7 7YE
- Croydon University Hospital
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Truro, Verenigd Koninkrijk
- Royal Cornwall Hospital
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Upton, Verenigd Koninkrijk, CH49 5PE
- Arrowe Park Hospital, Wirral
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Wakefield, Verenigd Koninkrijk
- Pinderfields General Hospital
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Warrington, Verenigd Koninkrijk
- Warrington Hospital
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Wishaw, Verenigd Koninkrijk, ML2 0DP
- Wishaw General Hospital
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Wolverhampton, Verenigd Koninkrijk, WV10 0QP
- New Cross Hospital
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Worcester, Verenigd Koninkrijk
- Worcestershire Royal Hospital
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York, Verenigd Koninkrijk, YO31 8HE
- York Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Gestational age at birth <32 weeks, or birth weight less than 1,500 g
- Receiving ≤30 ml/kg/day of milk at randomisation
- Written informed parental consent is obtained
To ensure the widest applicability to preterm infants across the United Kingdom, those exclusively breast milk fed, formula milk fed, or receiving mixed feeds will be included
Exclusion Criteria:
- Infants with a severe congenital anomaly
- Infants who, in the opinion of the treating clinician, have no realistic chance of survival
- Infants who are unlikely to be traceable for follow-up at 24 months of age corrected for prematurity (for example, infants of non-United Kingdom residents)
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Actieve vergelijker: Slower milk feed increment
Increase milk feeds by 18 ml/kg/day until on full milk feeds (tolerating 150 ml/kg/day for 3 consecutive days)
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Experimenteel: Faster milk feed increment
Increase milk feeds by 30 ml/kg/day until on full milk feeds (tolerating 150 ml/kg/day for 3 consecutive days)
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
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Survival without moderate or severe disability
Tijdsspanne: 24 months of age corrected for prematurity
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24 months of age corrected for prematurity
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Survival to discharge home
Tijdsspanne: Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Incidence of microbiologically-confirmed or clinically suspected late-onset invasive infection
Tijdsspanne: Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Incidence of necrotizing enterocolitis (Bell stage 2 or 3)
Tijdsspanne: Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Time taken to reach full milk feeds (tolerating 150 ml/kg/day for 3 consecutive days)
Tijdsspanne: Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Growth (weight and head circumference) at hospital discharge
Tijdsspanne: Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Measured by weight and head circumference z-scores
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Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Duration of parenteral feeding before hospital discharge
Tijdsspanne: Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Length of time in intensive care
Tijdsspanne: Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Length of hospital stay
Tijdsspanne: Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Participants will be followed from trial entry until hospital discharge (typically at 36 corrected weeks' gestation), an expected average of 8 weeks.
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Jon Dorling, MBChB DCH MD, Division of Neonatal-Perinatal Medicine, Dalhousie University, Halifax, NS, Canada
Publicaties en nuttige links
Nuttige links
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- SIFT01
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