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Bubble Continuous Positive Airway Pressure for Children With Severe Pneumonia in Mali, Africa

Not Applicable
Terminated
Conditions
Pneumonia
Interventions
Device: Bubble CPAP
Other: Standard Therapy
Registration Number
NCT03944551
Lead Sponsor
University of Maryland, Baltimore
Brief Summary

This study is being conducted in Mali, Africa.

Pneumonia is a respiratory infection of the lungs caused by bacteria or virus. Some children can develop signs of severe pneumonia and as a result, have difficulty breathing and low levels of oxygen in the blood. In some cases this can progress to death. Patients with signs of severe pneumonia require admission to the hospital for treatment and the treatment includes delivery of oxygen. Currently, in the hospital, oxygen is available for delivery by nasal cannula to children. In this case, oxygen is given through a small plastic tube which delivers oxygen through the nose. However, the amount of oxygen that can be given is limited because of the size of the tube and the amount of oxygen that can go through. However, a new device known as the bubble CPAP machine delivers oxygen through the nose in a way that helps the airways to stay open. This is known to provide better support to children less than 1 year of age who have difficulty breathing with signs of severe pneumonia. The purpose of this study is to evaluate the effectiveness of bubble CPAP in Children up to 5 years of age with with signs of severe pneumonia.

Detailed Description

This study includes two cohorts. One cohort will participate in an interventional clinical trial and the other cohort will participate in an observational study.

Interventional Cohort:

The first cohort will include 600 children with signs of severe pneumonia, 1 year up to 5 years of age. Signs of severe pneumonia include fast breathing, difficulty breathing and who are very sick (not able to drink, vomiting, having seizures, are very sleepy or with severe malnutrition). Two out of every three children will receive oxygen with the bubble CPAP and one out of every three children will receive treatment with oxygen with regular nasal cannula. The treatment assignment will be determined randomly. We will follow up participants during their entire hospitalization. During this time we will collect information on the child's illness, test results and treatment.

Observational Cohort:

The second cohort will include 450 children with signs of severe pneumonia, under 1 year of age. In Mali, bubble CPAP is currently given as standard of care (when possible) for children with signs of severe pneumonia, under 1 year of age; therefore, children in this cohort will already be receiving bubble CPAP as standard of care prior to enrollment. The only research activities will be to follow the children during their hospitalization and collect information about their clinical condition, test results, treatment and the amount of oxygen required during the hospital admission.

The remainder of the information in this ClinicalTrials.gov registration will refer only to the Intervention Cohort.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
13
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bubble CPAPBubble CPAP-
Standard TherapyStandard Therapy-
Primary Outcome Measures
NameTimeMethod
Treatment failure rate2 hours

We define treatment failure as the occurrence of any two or more of the following clinical criteria 2 hour after initiation of an intervention:

* Severe hypoxemia (Saturation of oxygen SpO2 \<85%) after being on one of the study groups treatments for 2 hours

* Increased in respiratory rate by any amount or if respiratory rate remains unchanged after initiation of treatment as follow:

* ≥ 40 breath/min in a child aged 12-23 months

* ≥ 30 breaths/min in a child aged 2-5 years

* Signs of persistent severe respiratory distress defined as head nodding, severe chest indrawing, stridor, apnea, nasal flaring and or grunting.

* Dies while in the hospital.

Secondary Outcome Measures
NameTimeMethod
Mortality rateThrough hospital discharge, an average of 1 week

The difference in mortality between the standard therapy group vs bCPAP group at the time of discharge.

Trial Locations

Locations (1)

Center for Vaccine Development - Mali

🇲🇱

Bamako, Mali

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