Effect of Continuous Positive Airway Pressure Delivered by Two Different Modalities on Breathing Pattern in Preterm Infants
Effects of Continuous Positive Airway Pressure (CPAP) Delivered by High Flow Nasal Cannula Versus Nasal Continuous Positive Airway Pressure on the Diaphragm Electrical Activity in Very Low Birth Weight Preterm Infants
研究概览
地位
条件
详细说明
Many preterm very low birth weight infants require continuous positive airway pressure(CPAP) for breathing support because of lung immaturity. CPAP can be delivered by the infant flow(TM) device which is well studied. Prolonged use of nasal prongs CPAP has been shown to cause discomfort and, rarely, nasal injury leading to long term disfigurement. On the other hand, High flow nasal cannula (HFNC) ,which is another modality of delivering CPAP, creates less pressure on the nose and less disfiguring effect but previous research showed that the use of HFNC may be less effective than IF-CPAP in providing breathing support in these infants.
We plan to study 10 stable preterm infants born less than 32 weeks' gestation and 1.5 kilograms at birth after being stable for at least 48hours on IF-CPAP. babies will be randomized to start on IF-CPAP or HFNC for 30 minutes. After 45 minutes of adaptation, baby will be switched to the other modality for another 30 minutes. By inserting a specialized feeding tube with sensors into the stomach, we can measure the electrical activity of the diaphragm (EAdi). By analysing EAdi with each modality of delivering CPAP, we want to directly assess how HFNC affects breathing compared to IF-CPAP.
研究类型
注册 (预期的)
联系人和位置
学习地点
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Ontario
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Toronto、Ontario、加拿大
- Sunnybrook Health Sciences Centre
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Birth weights ≤ 1500g
- Gestational age less than 32 week
- Stable on nasal continuous positive airway pressure (CPAP) of 5-6cmH20 support for at least 48 hours
- Treated with methylxanthines for apnea of prematurity
- In less than 35% oxygen
Exclusion Criteria:
- Congenital and acquired problem of the gastrointestinal tract
- Phrenic nerve injury and/or diaphragm paralysis
- Esophageal perforation/tracheoesophageal fistula
- 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 (e.g. CCAM)
- 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
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
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EAdi 1
babies in this group will first receive CPAP through IF-CPAP for 30 minutes.
After another 45 minutes, they will be switched to HFNC for 30 minutes.
EAdi will be recorded for the last 15 minutes of each 30 minutes period.
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EAdi 2
babies in this group will first receive CPAP through HFNC for 30 minutes.
After another 45 minutes, they will be switched to IF-CPAP for 30 minutes.
EAdi will be recorded for the last 15 minutes of each 30 minutes period.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
The difference in the tonic EAdi between IF-CPAP and HFNC .
大体时间:During the 4-hour study period.
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Patients will be randomized in two groups, one group will start on IF-CPAP for 30 minutes.
After another 45 minutes, this group will be switched to HFNC for another 30 minutes.
The other group will start on HFNC and then switched to IF-CPAP.
EAdi will be analyzed in the last 15 minutes of each 30 minutes period.
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During the 4-hour study period.
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Difference in the number of apnea episodes (breathing pauses) on EAdi recorded with each modality.
大体时间:During the 4-hour study period.
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During the 4-hour study period.
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Difference in episodes of clinically significant apnea with HFNC and IF-CPAP.
大体时间:During the 4-hour study period.
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During the 4-hour study period.
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Indices of respiratory muscle effort (inspiratory and expiratory) will be calculated from Edi waveform.
大体时间:During the 4-hour study period.
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These indices include the phasic Edi to the peak, mean inspiratory Edi, Edi-time product, post inspiratory activity and all neural timings.
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During the 4-hour study period.
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合作者和调查者
调查人员
- 首席研究员:Michael Dunn, MD、Sunnybrook Health Sciences Centre
- 首席研究员:Nehad Nasef, M.B.B.Ch、Sunnybrook Health Sciences Centre
- 首席研究员:Maureen Reilly, RRT、Sunnybrook Health Sciences Centre
- 首席研究员:Patti Schurr, RN(EC)、Sunnybrook Health Sciences Centre
- 首席研究员:Jennifer Beck, Ph.D.、Unity Health Toronto
- 研究主任:Eugene Ng, MD、Sunnybrook Health Sciences Centre
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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