- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT02421328
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
Visão geral do estudo
Status
Condições
Descrição detalhada
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.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Dakahlia
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Mansoura, Dakahlia, Egito, 35516
- Neonatal Intensive Care Unit, Mansoura University Children Hospital
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Mansoura, Dakahlia, Egito, 35516
- NICU, Mansoura University Children's Hospital
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição cruzada
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
---|---|
Comparador Ativo: 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.
|
Comparador Ativo: 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.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Diaphragmatic dimensions (inspiratory diaphragmatic thickness, expiratory diaphragmatic thickness and delta diaphragmatic thickness)
Prazo: 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.
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at the end of each 60 minutes epoch on nasal CPAP
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Right and left diaphragmatic excursion
Prazo: 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.
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at the end of each 60 minute epoch on CPAP
|
Diaphragmatic dimensions (inspiratory diaphragmatic thickness, expiratory diaphragmatic thickness and delta diaphragmatic thickness)
Prazo: 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
Prazo: 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
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Respiratory rate
Prazo: At the end of each 60 minutes epochs on CPAP and HHHFNC
|
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
Prazo: 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
Prazo: 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
Prazo: 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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Colaboradores e Investigadores
Patrocinador
Publicações e links úteis
Datas de registro do estudo
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Início do estudo (Real)
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Conclusão do estudo (Real)
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Mais Informações
Termos relacionados a este estudo
Outros números de identificação do estudo
- MS 874
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