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High Flow Nasal Cannula in Comparison With Nasal Continuous Positive Airway Pressure in the Management of Respiratory Distress Syndrome

Not Applicable
Completed
Conditions
Respiratory Distress Syndrome
Interventions
Device: HHHFNC
Device: NCPAP
Registration Number
NCT02587832
Lead Sponsor
Sidra Medicine
Brief Summary

To compare the primary outcome, failure of extubation defined by the need for re-intubation and mechanical ventilation within 5 days of initial extubation and secondary outcomes, morbidities and mortality after using of heated humidity high flow nasal cannula (HHHFNC) and Nasal Continuous Positive Airway Pressure (NCPAP) in the immediate post-extubation period for preterm infants between 24 and 28 weeks gestation with respiratory distress syndrome.

Detailed Description

Inclusion criteria were: 1) Preterm neonates with gestational age of 24 to 28 completed weeks. 2) In the case of twins, both neonates were included in the same treatment arm. 3) Success to wean with 24 hours to extubate. 4) Parental written informed consent for participation in the study obtained on admission into the hospital or prior to delivery.

Exclusion criteria were: 1) Evidence of severe birth asphyxia. 2) Known genetic or chromosomal disorders. 3) Infants delivered to mothers with ruptured membranes of more than three weeks duration. 4) Potentially life-threatening conditions unrelated to prematurity. 5) Participation in another clinical trial of any placebo, drug, biological, or device conducted under the provisions of a protocol.

Randomization A computer-generated block-randomization sequence with random block sizes was used. Infants who were part of multiple births underwent individual randomization. Clinicians opened consecutively numbered, sealed, brown envelopes immediately before extubation to determine the study-group assignment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  1. Preterm neonates with gestational age of 24 to 28 completed weeks.
  2. In the case of twins, both neonates were included in the same treatment arm.
  3. Success to wean with 24 hours to extubate.
  4. Parental written informed consent for participation in the study obtained on admission into the hospital or prior to delivery.
Exclusion Criteria
  1. Evidence of severe birth asphyxia.
  2. Known genetic or chromosomal disorders.
  3. Infants delivered to mothers with ruptured membranes of more than three weeks duration.
  4. Potentially life-threatening conditions unrelated to prematurity.
  5. Participation in another clinical trial of any placebo, drug, biological, or device conducted under the provisions of a protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
HHHFNCHHHFNCRandomized to HHHFNC
NCPAPNCPAPRandomized to NCPAP
Primary Outcome Measures
NameTimeMethod
the need for re-intubation5 DAYS

The primary outcome measured was failed extubation defined by the need for re-intubation and mechanical ventilation within five days of initial extubation.

Secondary Outcome Measures
NameTimeMethod
Duration of respiratory support using HHHFNC /NCPAP.through study completion, an average of 1 year.
Incidence of nasal breakdownthrough study completion, an average of 24 weeks
intraventricular hemorrhage (IVH),through study completion, an average of 24 weeks
retinopathy of prematurity (ROP)through study completion, an average of 24 weeks

number of participants with sepsis will be compared between the two arms. Sepsis was defined as a positive culture result from blood with concomitant clinical symptoms. Positive cultures were defined as having positive growth from the cerebrospinal fluid, tracheal, blood, or urine specimens.

sepsisthrough study completion, an average of 1 year.

Trial Locations

Locations (1)

Akron Children's Hospital

🇺🇸

Akron, Ohio, United States

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