Comparison of Efficacy of Less Invasive Surfactant Treatment Under Nasal CPAP and Nasal IPPV in Premature Babies: CURLISPAP Study
Overview
- Phase
- Not Applicable
- Intervention
- NCPAP
- Conditions
- Respiratory Distress Syndrome
- Sponsor
- Uludag University
- Enrollment
- 85
- Locations
- 1
- Primary Endpoint
- Treatment failure within 72 hours after randomization 72 hours after randomization
- Status
- Completed
- Last Updated
- 2 months ago
Overview
Brief Summary
Non invasive ventilation is important in the care of preterm infants with respiratory failure, and surfactant treatment can be use with non invasive ventilation. However, there is no consensus on the best non-invasive ventilation mode for surfactant treatment in preterm infants.
Objective: To compare the effectiveness of nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (CPAP) in preterm infants ≤ 29 week gestational age.
Detailed Description
This CURLISPAP study was a multicenter, randomized controlled study at six level III neonatal intensive care units (NICUs) in Turkey. The protocol was approved by the ethics committee of each participating centre and Turkish Ministry of Health, Turkish Medicines and Medical Devices Agency. Non invasive ventilated preterm infants with respiratory distress syndrome and gestational age from 241/7 weeks to 296/7 weeks were enrolled within 6 h of birth. Infants with major congenital malformations, need of mechanical ventiation, need of entubation in delivery room and lack of parental consent were excluded. Enrolled infants will randomize into two study groups (NIPPV group and CPAP group). The short binasal prongs will use as interface. For all the groups, if the fraction of inspired oxygen (FiO2) requirement is persistently higher than 0.30 target SpO2 90-94%. For all groups Surfactant by "LISA" technique and with special catheter (LISAcath, Chiesi Pharmaceutics) of surfactant (Curosurf, Chiesi Pharmaceutics) 200 mg/kg. The primary end-point, need of mechanical ventilation within 72 hours following surfactant treatment, will compared between the groups. Short and long-term neonatal outcomes will also evaluate.
Investigators
Hilal Ozkan
Professor
Uludag University
Eligibility Criteria
Inclusion Criteria
- •Gestational age 24 -29 week
- •Clinical and radiological diagnosis of RDS
- •Born in a hospital with a study center
- •Spontaneous breathing
- •Within the first 6 hours
- •Non-invasive ventilation and FiO2 requirement \>0.30
- •Parental concent
Exclusion Criteria
- •Major congenital malformations
- •Need of mechanical ventiation
- •Need of entubation in delivery room
- •Air weak syndrome
- •No parental concent
Arms & Interventions
NCPAP
Ventilator-derived NCPAP will be administered using binasal prongs. Standard Devices or infant flow-driver device. Initial NCPAP settings are: PEEP:6 cmH2O and FiO2: adjusted to keep preductal sPO2 between %90-94. Failure is defined as FiO2 requirement of \>%50, capillary blood gas obtained at the 4th hour of therapy showing pH\<7.20 or pCO2\>60 cmH2O.
Intervention: NCPAP
NCPAP
Ventilator-derived NCPAP will be administered using binasal prongs. Standard Devices or infant flow-driver device. Initial NCPAP settings are: PEEP:6 cmH2O and FiO2: adjusted to keep preductal sPO2 between %90-94. Failure is defined as FiO2 requirement of \>%50, capillary blood gas obtained at the 4th hour of therapy showing pH\<7.20 or pCO2\>60 cmH2O.
Intervention: NIPPV
NIPPV
Ventilator-derived NIPPV will be administered using binasal prongs. Standard Devices or infant flow-driver device. Initial NIPPV settings are: PEEP:6 cmH2O, PIP: 15 cmH2O, Rate: 30-40/ bpm and FiO2: adjusted to keep preductal sPO2 between %90-94. Failure is defined as FiO2 requirement of \>%50, capillary blood gas obtained at the 4th hour of therapy showing pH\<7.20 or pCO2\>60 cmH2O.
Intervention: NCPAP
NIPPV
Ventilator-derived NIPPV will be administered using binasal prongs. Standard Devices or infant flow-driver device. Initial NIPPV settings are: PEEP:6 cmH2O, PIP: 15 cmH2O, Rate: 30-40/ bpm and FiO2: adjusted to keep preductal sPO2 between %90-94. Failure is defined as FiO2 requirement of \>%50, capillary blood gas obtained at the 4th hour of therapy showing pH\<7.20 or pCO2\>60 cmH2O.
Intervention: NIPPV
Outcomes
Primary Outcomes
Treatment failure within 72 hours after randomization 72 hours after randomization
Time Frame: within 72 hours after randomization
Need for invasive mechanical ventilation
Secondary Outcomes
- Rate of bronchopulmonary dysplasia(36 weeks of postmenstrual age ])