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High-Flow Nasal Cannula Versus Nasal CPAP as Primary Support in Preterm Respiratory Distress Syndrome
3 juli 2026 bijgewerkt door: 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.
Studie Overzicht
Toestand
Voltooid
Gedetailleerde beschrijving
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.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
86
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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Kayseri
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Kayseri, Kayseri, Turkije (Türkiye), 38090
- Kayseri City Hospital
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
Accepteert gezonde vrijwilligers
Nee
Beschrijving
Inclusion Criteria:
Preterm infants admitted to the NICU who fulfilled all of the following were eligible:
- Gestational age (GA) 28+0 to 34+6 weeks and/or birth weight 1,000-2,000 g
- Clinical and radiological diagnosis of moderate respiratory distress syndrome (RDS)
- Silverman-Anderson score (SAS) 4 < SAS < 7
- Eligibility for noninvasive ventilatory support
Exclusion Criteria:
- Parental refusal of consent
- Outborn infants transferred from other centers
- Infants who required immediate intubation in the delivery room
- Major congenital anomalies, chromosomal disorders, gastrointestinal malformations, or life-threatening congenital cardiac defects
- Nasal/pharyngeal anatomical anomalies (choanal atresia, cleft palate/lip)
- Moderate-to-severe hypoxic-ischemic encephalopathy (Grade 2-3)
- Infants who died unexpectedly shortly after admission without respiratory evaluation
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: 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%.
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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%.
Andere namen:
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Actieve vergelijker: 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%.
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nCPAP delivered via a ventilator-driven system; pressure 5-8 cmH2O; FiO2 titrated to maintain SpO2 91-95%.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Number of Participants With Treatment Failure Requiring Invasive Mechanical Ventilation
Tijdsspanne: First 7 days of life (assessed at 72 hours, Day 5, and Day 7)
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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.
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First 7 days of life (assessed at 72 hours, Day 5, and Day 7)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Number of Participants With Nasal Trauma
Tijdsspanne: 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.
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During noninvasive respiratory support (first 7 days of life)
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Number of Participants With Proven (Culture-Positive) Late-Onset Sepsis
Tijdsspanne: From 72 hours of life through hospital discharge, an average of 24 days
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Culture-positive late-onset sepsis with onset after 72 hours of life.
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From 72 hours of life through hospital discharge, an average of 24 days
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Number of Participants With Bronchopulmonary Dysplasia (BPD)
Tijdsspanne: At 36 weeks postmenstrual age
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BPD defined as an oxygen requirement at 36 weeks postmenstrual age.
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At 36 weeks postmenstrual age
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Number of Participants With Patent Ductus Arteriosus (PDA) Requiring Treatment
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
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PDA requiring medical or surgical treatment.
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From randomization through hospital discharge, an average of 24 days
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Number of Participants With Intraventricular Hemorrhage (IVH) of Any Grade
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
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IVH of any grade detected on cranial ultrasound.
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From randomization through hospital discharge, an average of 24 days
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Number of Participants With Necrotizing Enterocolitis (NEC) of Any Stage
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
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NEC of any stage.
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From randomization through hospital discharge, an average of 24 days
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Number of Participants With Retinopathy of Prematurity (ROP)
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
|
ROP of any stage on ophthalmologic examination.
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From randomization through hospital discharge, an average of 24 days
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Number of Participants With Periventricular Leukomalacia (PVL)
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
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PVL detected on cranial imaging.
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From randomization through hospital discharge, an average of 24 days
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Number of Participants With Feeding Intolerance
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
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Feeding intolerance per pre-specified clinical criteria.
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From randomization through hospital discharge, an average of 24 days
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Days to Full Enteral Feeding
Tijdsspanne: From birth until full enteral feeding is achieved, an average of 8 days
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Number of days from birth to achievement of full enteral feeding (>=120 mL/kg/day).
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From birth until full enteral feeding is achieved, an average of 8 days
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Duration of Total Parenteral Nutrition (TPN)
Tijdsspanne: From birth through hospital discharge, an average of 24 days
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Total duration of parenteral nutrition, in days.
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From birth through hospital discharge, an average of 24 days
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Duration of Total Oxygen Support
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
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Total duration of any oxygen support, in days.
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From randomization through hospital discharge, an average of 24 days
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Number of Participants With All-Cause In-Hospital Mortality
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
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All-cause mortality during hospitalization.
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From randomization through hospital discharge, an average of 24 days
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Number of Participants With Air Leak Syndrome
Tijdsspanne: First 7 days of life (respiratory support period)
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Air leak syndrome, including pneumothorax.
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First 7 days of life (respiratory support period)
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Number of Participants With Clinically Significant Apnea
Tijdsspanne: First 7 days of life (respiratory support period)
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Clinically significant apnea episodes.
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First 7 days of life (respiratory support period)
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Discharge Weight
Tijdsspanne: At hospital discharge, an average of 24 days after randomization
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Body weight at hospital discharge, in grams.
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At hospital discharge, an average of 24 days after randomization
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Hospital Length of Stay
Tijdsspanne: From randomization through hospital discharge, an average of 24 days
|
Total length of hospital stay, in days.
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From randomization through hospital discharge, an average of 24 days
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Sweet DG, Carnielli VP, Greisen G, Hallman M, Klebermass-Schrehof K, Ozek E, Te Pas A, Plavka R, Roehr CC, Saugstad OD, Simeoni U, Speer CP, Vento M, Visser GHA, Halliday HL. European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update. Neonatology. 2023;120(1):3-23. doi: 10.1159/000528914. Epub 2023 Feb 15.
- Hodgson KA, Wilkinson D, De Paoli AG, Manley BJ. Nasal high flow therapy for primary respiratory support in preterm infants. Cochrane Database Syst Rev. 2023 May 5;5(5):CD006405. doi: 10.1002/14651858.CD006405.pub4.
- Bruet S, Butin M, Dutheil F. Systematic review of high-flow nasal cannula versus continuous positive airway pressure for primary support in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2022 Jan;107(1):56-59. doi: 10.1136/archdischild-2020-321094. Epub 2021 May 20.
- Luo K, Huang Y, Xiong T, Tang J. High-flow nasal cannula versus continuous positive airway pressure in primary respiratory support for preterm infants: A systematic review and meta-analysis. Front Pediatr. 2022 Nov 21;10:980024. doi: 10.3389/fped.2022.980024. eCollection 2022.
- Aramesh MR, et al. nCPAP vs HFNC for RDS in preterm neonates: a RCT. Curr Respir Med Rev. 2025;21(3). doi:10.2174/011573398X339994241209170750
- Singh S, Ananthan A, Nanavati R. Post-INSURE Administration of Heated Humidified High-Flow Therapy Versus Nasal Continuous Positive Airway Pressure in Preterm Infants More Than 28 Weeks Gestation with Respiratory Distress Syndrome: A Randomized Non-Inferiority Trial. J Trop Pediatr. 2022 Jun 6;68(4):fmac062. doi: 10.1093/tropej/fmac062.
- Demirel G, Vatansever B, Tastekin A. High Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure for Primary Respiratory Support in Preterm Infants: A Prospective Randomized Study. Am J Perinatol. 2021 Feb;38(3):237-241. doi: 10.1055/s-0039-1696673. Epub 2019 Sep 28.
- Murki S, Singh J, Khant C, Kumar Dash S, Oleti TP, Joy P, Kabra NS. High-Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure for Primary Respiratory Support in Preterm Infants with Respiratory Distress: A Randomized Controlled Trial. Neonatology. 2018;113(3):235-241. doi: 10.1159/000484400. Epub 2018 Jan 23.
- Lavizzari A, Colnaghi M, Ciuffini F, Veneroni C, Musumeci S, Cortinovis I, Mosca F. Heated, Humidified High-Flow Nasal Cannula vs Nasal Continuous Positive Airway Pressure for Respiratory Distress Syndrome of Prematurity: A Randomized Clinical Noninferiority Trial. JAMA Pediatr. 2016 Aug 8. doi: 10.1001/jamapediatrics.2016.1243. Online ahead of print.
- Roberts CT, Owen LS, Manley BJ, Froisland DH, Donath SM, Dalziel KM, Pritchard MA, Cartwright DW, Collins CL, Malhotra A, Davis PG; HIPSTER Trial Investigators. Nasal High-Flow Therapy for Primary Respiratory Support in Preterm Infants. N Engl J Med. 2016 Sep 22;375(12):1142-51. doi: 10.1056/NEJMoa1603694.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
1 juni 2020
Primaire voltooiing (Werkelijk)
1 mei 2022
Studie voltooiing (Werkelijk)
1 mei 2022
Studieregistratiedata
Eerst ingediend
16 juni 2026
Eerst ingediend dat voldeed aan de QC-criteria
3 juli 2026
Eerst geplaatst (Werkelijk)
9 juli 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
9 juli 2026
Laatste update ingediend die voldeed aan QC-criteria
3 juli 2026
Laatst geverifieerd
1 juni 2026
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Verloskundige arbeid, voortijdig
- Verloskundige arbeidscomplicaties
- Zwangerschap Complicaties
- Ziekten van de luchtwegen
- Longziekten
- Ademhalingsstoornissen
- Zuigelingen, prematuren, ziekten
- Baby, pasgeborene, ziekten
- Ademnoodsyndroom
- Aangeboren, erfelijke en neonatale ziekten en afwijkingen
- Voortijdige geboorte
- Ademhalingsnoodsyndroom, pasgeborene
Andere studie-ID-nummers
- Ethics C.D.No:141(Kayseri CH)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
NEE
Beschrijving IPD-plan
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.
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .