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The Effect of Surfactant Dose on Outcomes in Preterm Infants With RDS

Active, not recruiting
Conditions
Respiratory Distress Syndrome
Bronchopulmonary Dysplasia
Registration Number
NCT03808402
Lead Sponsor
Chiesi UK
Brief Summary

A prospective observational study using de-identified data from the Neonatal Network Research Database (NNRD) supplemented by additional information on dose, method of surfactant administration and dosing frequency to assess whether the dose and method of administration of surfactant given to preterm infants with respiratory distress syndrome (RDS) affects neonatal outcomes.

Detailed Description

The rationale for this study is the clinical relevance of understanding whether surfactant dose affects neonatal outcomes in infants with RDS who are treated in the immediate postnatal period.

In a research environment, the dose of surfactant is rigorously controlled, usually administered at a dose of 100mg/kg or 200mg/kg. In clinical practice, clinicians more frequently follow the 'whole vial dosing' approach, where a full vial is given aiming to get as close as possible to the desired dose. Reasons for whole vial use include reduction of waste and administration of surfactant shortly after birth where an infant's weight is unknown. It is unclear whether whole vial dosing leads to under-dosing or over-dosing and whether either situation affects outcomes.

Information regarding the dose of surfactant delivered, and the method of administration, are not currently routinely recorded in the UK.

The primary objective of the study is to compare two dosing groups (100-130 mg/kg and 170-200 mg/kg) in terms of the proportions of infants who require mechanical ventilation within four days of birth.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
2973
Inclusion Criteria
  • <37 weeks gestational age Requiring surfactant for Respiratory Distress Syndrome Record of birth weight available Born after study initiation
Exclusion Criteria
  • 37 weeks gestation age or above Parental opt-out

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Need for mechanical ventilationDay 3 to 4 of life

Survival without mechanical ventilation (excluding days 1 and 2 of life)

Secondary Outcome Measures
NameTimeMethod
Total cumulative dose of surfactant (excluding the first dose)To study completion, an average of 2 years
Survival with no oxygen requirementTo study completion, an average of 2 years
Duration of mechanical ventilation (days)To study completion, an average of 2 years
Duration of respiratory support (days)To study completion, an average of 2 years
SurvivalTo study completion, an average of 2 years
Number of doses of surfactantTo study completion, an average of 2 years
Survival with no respiratory support36 weeks gestation
Two-year developmental outcomesTwo years

As measured by Composite Developmental Assessment

Trial Locations

Locations (29)

William Harvey Hospital

🇬🇧

Ashford, Kent, United Kingdom

Birmigham Heartlands Hospital

🇬🇧

Birmingham, United Kingdom

Bradford Royal Infirmary

🇬🇧

Bradford, United Kingdom

The Rosie Hospital

🇬🇧

Cambridge, United Kingdom

University Hospital Coventry

🇬🇧

Coventry, United Kingdom

St Peter's Hospital

🇬🇧

Chertsey, United Kingdom

Hull Royal Infirmary

🇬🇧

Hull, United Kingdom

Leeds General Infirmary

🇬🇧

Leeds, United Kingdom

Homerton Hospital

🇬🇧

London, United Kingdom

University College Hospital

🇬🇧

London, United Kingdom

The James Cook Hospital

🇬🇧

Middlesbrough, United Kingdom

University Hospital of North Tees

🇬🇧

Middlesbrough, United Kingdom

Royal Victoria Infirmary

🇬🇧

Newcastle, United Kingdom

Queens Medical Centre

🇬🇧

Nottingham, United Kingdom

Royal Oldham Hospital

🇬🇧

Oldham, United Kingdom

Jessop Wing

🇬🇧

Sheffield, United Kingdom

Princess Anne Hospital

🇬🇧

Southampton, United Kingdom

Birmingham Women's Hospital

🇬🇧

Birmingham, United Kingdom

Royal Bolton Hospital

🇬🇧

Bolton, United Kingdom

Burnley General Hospital

🇬🇧

Burnley, United Kingdom

Leicester Royal Infirmary

🇬🇧

Leicester, United Kingdom

Liverpool Women's Hospital

🇬🇧

Liverpool, United Kingdom

Guy's and St Thomas' Hospital

🇬🇧

London, United Kingdom

Chelsea and Westminster Hospital

🇬🇧

London, United Kingdom

St Mary's Hospital

🇬🇧

Manchester, United Kingdom

Norfolk and Norwich University Hospital

🇬🇧

Norwich, United Kingdom

Wythenshawe Hospital

🇬🇧

Manchester, United Kingdom

Queen Alexandra Hospital

🇬🇧

Portsmouth, United Kingdom

John Radcliffe Hospital

🇬🇧

Oxford, United Kingdom

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