Non-inflatable Supraglottic Airway (NI-SGA) vs. Face Mask (FM) as a Primary Interface Device for Neonatal Resuscitation
3. mai 2018 oppdatert av: University of Oklahoma
Non-inflatable Supraglottic Airway (NI-SGA) vs. Face Mask (FM) as a Primary Interface Device for Neonatal Resuscitation: A Pilot Study
Prospective, randomized controlled trial to be performed at one center, of term and late preterm infants requiring resuscitation.
Prenatal consent will be obtained.
At randomization, babies will be resuscitated following Neonatal Resuscitation Program (NRP) guidelines and ventilated using the T-piece resuscitator with either a Face Mask (FM) or Non-inflating supraglottic airway.
Video will be collected during resuscitation as well as written documentation.
Primary outcome will be time to spontaneous breathing, length of resuscitation, and need for endotracheal intubation.
Studieoversikt
Status
Tilbaketrukket
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Mothers who are close to delivery of a term or near term infant with estimated fetal weight of 2500gms will be approached for consent to randomize their infant to resuscitation with mask or non-inflatable supraglottic airway (NISGA) if resuscitation is required.
Study personnel in delivery will open sequential envelopes with randomized code to indicate which device is to be used if necessary.
The resuscitator will be blinded until determination of need of respiratory support.
At that time, the appropriate randomized device (face mask or NISGA) will be handed to the resuscitator for use along with T-Piece resuscitator.
Video data capture will be used to record type, length and response to resuscitation.
This information will be translated to a database prior to destruction of video.
Studietype
Intervensjonell
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Forente stater, 73117
- University of Oklahoma Health Sciences Center
-
-
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Ikke eldre enn 30 minutter (Barn)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- Newborns > or = 2000gms requiring positive pressure ventilation within the first 2 minutes of life
Exclusion Criteria:
- Newborns with expected fetal weight <2000 grams
- Known congenital malformations
- Multiple gestation (twins and above)
- History of meconium stained fluid
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Aktiv komparator: Face Mask
Standard Face Mask with T piece resuscitator for neonatal resuscitation.
Face mask placement per Neonatal Resuscitation Program resuscitation guideline.
|
at delivery - standard airway management per Neonatal Resuscitation Program utilizing face mask.
T-Piece Resuscitator for providing postivie pressure ventilation via face mask or non-inflatable supraglottic airway
|
|
Aktiv komparator: Non-inflatable supraglottic airway
Use of non-inflating supraglottic airway with T-piece resuscitator instead of Standard Face Mask with T piece resuscitator for neonatal resuscitation, replacing standard of care face mask in Neonatal Resuscitation Program guideline.
|
T-Piece Resuscitator for providing postivie pressure ventilation via face mask or non-inflatable supraglottic airway
at delivery if resuscitation is required infant randomized to NI-SGA or face mask as the interface for positive pressure ventilation.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Time to Spontaneous Breathing
Tidsramme: 30 minutes
|
Record of time from beginning of resuscitation to time of spontaneous breathing
|
30 minutes
|
|
Duration of Positive Pressure Ventilation
Tidsramme: 30 minutes
|
Total time of positive pressure ventilation required to adequate spontaneous breathing.
|
30 minutes
|
|
Need for subsequent endotracheal intubation
Tidsramme: 30 minutes
|
Failure of non-invasive resuscitative efforts by face mask or NI-SGA requiring intubation per NRP guideline.
|
30 minutes
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Time needed for NI-SGA placement
Tidsramme: 1 minute
|
Time needed adequate placement of non-inflatable supraglottic airway
|
1 minute
|
|
Need for drugs in resuscitation
Tidsramme: 30 minutes
|
Drug administration as part of the standard neonatal resuscitation per NRP
|
30 minutes
|
|
Use of Chest Compressions
Tidsramme: 30 minutes
|
Need for chest compressions as part of neonatal resuscitation per NRP guidelines
|
30 minutes
|
|
Use of oxygen
Tidsramme: 30 minutes
|
Amount and duration of oxygen use in resuscitation
|
30 minutes
|
|
Rate of complications associated with resuscitation
Tidsramme: 30 minutes
|
Presence of complications including bleeding, abdominal distension, laryngeal stridor
|
30 minutes
|
|
Heart rate 2 minutes after initiation of resuscitation
Tidsramme: 2 minutes
|
Heart rate assessed at 2 minutes
|
2 minutes
|
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Maximum inspiratory pressure
Tidsramme: 30 minutes
|
Record of highest peak inspiratory pressure used in resuscitation
|
30 minutes
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Etterforskere
- Hovedetterforsker: Arlen Foulks, DO, University of Oklahoma
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
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- Kattwinkel J, Perlman JM, Aziz K, Colby C, Fairchild K, Gallagher J, Hazinski MF, Halamek LP, Kumar P, Little G, McGowan JE, Nightengale B, Ramirez MM, Ringer S, Simon WM, Weiner GM, Wyckoff M, Zaichkin J. Part 15: neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S909-19. doi: 10.1161/CIRCULATIONAHA.110.971119. No abstract available. Erratum In: Circulation. 2011 Oct 11;124(15):e406.
- Ersdal HL, Mduma E, Svensen E, Perlman JM. Early initiation of basic resuscitation interventions including face mask ventilation may reduce birth asphyxia related mortality in low-income countries: a prospective descriptive observational study. Resuscitation. 2012 Jul;83(7):869-73. doi: 10.1016/j.resuscitation.2011.12.011. Epub 2011 Dec 23.
- Zhu XY, Lin BC, Zhang QS, Ye HM, Yu RJ. A prospective evaluation of the efficacy of the laryngeal mask airway during neonatal resuscitation. Resuscitation. 2011 Nov;82(11):1405-9. doi: 10.1016/j.resuscitation.2011.06.010. Epub 2011 Jul 16.
- Schmolzer GM, Kamlin OC, O'Donnell CP, Dawson JA, Morley CJ, Davis PG. Assessment of tidal volume and gas leak during mask ventilation of preterm infants in the delivery room. Arch Dis Child Fetal Neonatal Ed. 2010 Nov;95(6):F393-7. doi: 10.1136/adc.2009.174003. Epub 2010 Jun 14.
- Bernhard M, Benger JR. Airway management during cardiopulmonary resuscitation. Curr Opin Crit Care. 2015 Jun;21(3):183-7. doi: 10.1097/MCC.0000000000000201.
- Ersdal HL, Singhal N. Resuscitation in resource-limited settings. Semin Fetal Neonatal Med. 2013 Dec;18(6):373-8. doi: 10.1016/j.siny.2013.07.001. Epub 2013 Jul 27.
- Wyckoff MH, Perlman JM. Effective ventilation and temperature control are vital to outborn resuscitation. Prehosp Emerg Care. 2004 Apr-Jun;8(2):191-5. doi: 10.1016/j.prehos.2003.12.013.
- Wyckoff MH, Perlman JM, Laptook AR. Use of volume expansion during delivery room resuscitation in near-term and term infants. Pediatrics. 2005 Apr;115(4):950-5. doi: 10.1542/peds.2004-0913.
- Szyld E, Aguilar A, Musante GA, Vain N, Prudent L, Fabres J, Carlo WA; Delivery Room Ventilation Devices Trial Group. Comparison of devices for newborn ventilation in the delivery room. J Pediatr. 2014 Aug;165(2):234-239.e3. doi: 10.1016/j.jpeds.2014.02.035. Epub 2014 Mar 29.
- Kattwinkel J, Perlman JM, Aziz K, Colby C, Fairchild K, Gallagher J, Hazinski MF, Halamek LP, Kumar P, Little G, McGowan JE, Nightengale B, Ramirez MM, Ringer S, Simon WM, Weiner GM, Wyckoff M, Zaichkin J; American Heart Association. Neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics. 2010 Nov;126(5):e1400-13. doi: 10.1542/peds.2010-2972E. Epub 2010 Oct 18. No abstract available. Erratum In: Pediatrics. 2011 Jul;128(1):176.
- O'Donnell CP, Davis PG, Morley CJ. Positive pressure ventilation at neonatal resuscitation: review of equipment and international survey of practice. Acta Paediatr. 2004 May;93(5):583-8. doi: 10.1111/j.1651-2227.2004.tb02981.x.
- Hartung JC, te Pas AB, Fischer H, Schmalisch G, Roehr CC. Leak during manual neonatal ventilation and its effect on the delivered pressures and volumes: an in vitro study. Neonatology. 2012;102(3):190-5. doi: 10.1159/000339325. Epub 2012 Jul 10.
- Deindl P, O'Reilly M, Zoller K, Berger A, Pollak A, Schwindt J, Schmolzer GM. Influence of mask type and mask position on the effectiveness of bag-mask ventilation in a neonatal manikin. Eur J Pediatr. 2014 Jan;173(1):75-9. doi: 10.1007/s00431-013-2122-4. Epub 2013 Aug 11.
- Schilleman K, van der Pot CJ, Hooper SB, Lopriore E, Walther FJ, te Pas AB. Evaluating manual inflations and breathing during mask ventilation in preterm infants at birth. J Pediatr. 2013 Mar;162(3):457-63. doi: 10.1016/j.jpeds.2012.09.036. Epub 2012 Oct 25.
- Foglia EE, Owen LS, Thio M, Ratcliffe SJ, Lista G, Te Pas A, Hummler H, Nadkarni V, Ades A, Posencheg M, Keszler M, Davis P, Kirpalani H. Sustained Aeration of Infant Lungs (SAIL) trial: study protocol for a randomized controlled trial. Trials. 2015 Mar 15;16:95. doi: 10.1186/s13063-015-0601-9.
- Richmond S, Wyllie J. European Resuscitation Council Guidelines for Resuscitation 2010 Section 7. Resuscitation of babies at birth. Resuscitation. 2010 Oct;81(10):1389-99. doi: 10.1016/j.resuscitation.2010.08.018. No abstract available.
- Schmolzer GM, Agarwal M, Kamlin CO, Davis PG. Supraglottic airway devices during neonatal resuscitation: an historical perspective, systematic review and meta-analysis of available clinical trials. Resuscitation. 2013 Jun;84(6):722-30. doi: 10.1016/j.resuscitation.2012.11.002. Epub 2012 Nov 9.
- Leone TA, Rich W, Finer NN. A survey of delivery room resuscitation practices in the United States. Pediatrics. 2006 Feb;117(2):e164-75. doi: 10.1542/peds.2005-0936.
- Schreiner MS, Feltman D, Wiswell T, Wootton S, Arnold C, Tyson J, Lantos JD. When is waiver of consent appropriate in a neonatal clinical trial? Pediatrics. 2014 Nov;134(5):1006-12. doi: 10.1542/peds.2014-0207. Epub 2014 Oct 6.
- Nichol G, Huszti E. Design and implementation of resuscitation research: special challenges and potential solutions. Resuscitation. 2007 Jun;73(3):337-46. doi: 10.1016/j.resuscitation.2006.10.021. Epub 2007 Feb 9.
- Paterson SJ, Byrne PJ, Molesky MG, Seal RF, Finucane BT. Neonatal resuscitation using the laryngeal mask airway. Anesthesiology. 1994 Jun;80(6):1248-53; discussion 27A.
- Gandini D, Brimacombe JR. Neonatal resuscitation with the laryngeal mask airway in normal and low birth weight infants. Anesth Analg. 1999 Sep;89(3):642-3. doi: 10.1097/00000539-199909000-00018. No abstract available.
- Zanardo V, Weiner G, Micaglio M, Doglioni N, Buzzacchero R, Trevisanuto D. Delivery room resuscitation of near-term infants: role of the laryngeal mask airway. Resuscitation. 2010 Mar;81(3):327-30. doi: 10.1016/j.resuscitation.2009.11.005. Epub 2009 Dec 22.
- Trevisanuto D, Cavallin F, Nguyen LN, Nguyen TV, Tran LD, Tran CD, Doglioni N, Micaglio M, Moccia L. Supreme Laryngeal Mask Airway versus Face Mask during Neonatal Resuscitation: A Randomized Controlled Trial. J Pediatr. 2015 Aug;167(2):286-91.e1. doi: 10.1016/j.jpeds.2015.04.051. Epub 2015 May 21.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Forventet)
15. april 2018
Primær fullføring (Forventet)
15. april 2018
Studiet fullført (Forventet)
15. april 2018
Datoer for studieregistrering
Først innsendt
10. desember 2015
Først innsendt som oppfylte QC-kriteriene
10. desember 2015
Først lagt ut (Anslag)
14. desember 2015
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
9. mai 2018
Siste oppdatering sendt inn som oppfylte QC-kriteriene
3. mai 2018
Sist bekreftet
1. mai 2018
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
- 5848
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Ja
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Nei
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