Premature Infants in Need of Transfusion (PINT)
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Purpose
Hypothesis: That a high hemoglobin threshold for transfusion in extremely low birth weight (ELBW) infants is associated with a lower rate of survival without severe morbidity (defined as one or more of retinopathy of prematurity, bronchopulmonary dysplasia, or periventricular leukomalacia/ventriculomegaly).
Primary Objective: To determine whether either a liberal or more restrictive threshold of hemoglobin level for red cell transfusion in ELBW infants is safer, by randomizing to either a high transfusion hemoglobin threshold or a low transfusion hemoglobin threshold.
Follow-up at a corrected age of 18 months represents a conventional age at which to first assess neurodevelopmental outcomes, and to predict long-term outcomes.
| Condition | Intervention | Phase |
|---|---|---|
|
Anemia of Prematurity |
Procedure: Red blood cell transfusion |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized Controlled Trial of Two Hemoglobin Thresholds for Transfusion in Newborns <1000g Birth Weight |
- Neonatal phase:
- Survival to tertiary hospital discharge without severe morbidity (one or all of bronchopulmonary dysplasia, retinopathy of prematurity Grade 3-4, periventricular leukomalacia/ventriculomegaly present on ultra-sound scans at corrected age 34 weeks)
- Follow-up phase:
- Combined mortality or neurodevelopmental disability (non-ambulatory cerebral palsy, blindness, deafness, cognitive delay) at 18 months corrected age
- Neonatal phase:
- growth in weight and head circumference
- time to extubation
- time on oxygen
- length of hospital stay until discharge home
- incidences of necrotizing enterocolitis
- apnea requiring treatment
- number of infections
- use of post-natal steroids
- intraventricular hemorrhage Grade 4 or with hydrocephalus
- mean levels of hemoglobin
- number of transfusions
- number of donor exposures
- Follow-up phase:
- milder forms of cerebral palsy
- milder neurologic disorder
- personal and social functional capabilities
- hydrocephalus requiring a shunt
- seizure disorder
- respiratory disease
- iron nutritional status
- physical growth including head size
| Estimated Enrollment: | 424 |
| Study Start Date: | February 2001 |
Eligibility| Ages Eligible for Study: | up to 48 Hours |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- birth weight <1000g
- postnatal age <48 hours
- no transfusion beyond first 6 hours of life
- estimated gestational age of 30 completed weeks or less
Exclusion Criteria:
- infant considered non-viable by attending physician
- infant has cyanotic congenital heart disease
- infant's parents known to be opposed to blood transfusion
- either parent has hemoglobinopathies or congenital anemias
- infant has hemolytic disease
- infant has severe acute hemorrhage, severe shock, severe sepsis with coagulopathy or requires peri-operative transfusion
- prior treatment with or intention to treat with erythropoietin
Contacts and Locations| United States, New York | |
| Albany Medical Center | |
| Albany, New York, United States, 12208 | |
| Brooklyn Hospital Center | |
| Brooklyn, New York, United States, 11201 | |
| Australia, Victoria | |
| Mercy Hospital for Women | |
| Melbourne, Victoria, Australia, 3084 | |
| Royal Women's Hospital | |
| Melbourne, Victoria, Australia, 3053 | |
| Canada, Alberta | |
| Royal Alexandra Hospital | |
| Edmonton, Alberta, Canada, T5H 3T9 | |
| Canada, Nova Scotia | |
| IWK Health Centre | |
| Halifax, Nova Scotia, Canada, B3P 1R8 | |
| Canada, Ontario | |
| McMaster University | |
| Hamilton, Ontario, Canada, L8S 4J9 | |
| Kingston General Hospital | |
| Kingston, Ontario, Canada, K7L 2V7 | |
| Sunnybrook & Women's College Health Science Centre | |
| Toronto, Ontario, Canada, M5S 1B2 | |
| Canada, Quebec | |
| Royal Victoria Hospital | |
| Montreal, Quebec, Canada, H3A 1A1 | |
| Principal Investigator: | Haresh Kirpalani, MD, MSc | McMaster University |
| Principal Investigator: | Robin K Whyte, MD | Dalhousie University |
| Study Director: | Robin S Roberts, MTech | McMaster University |
| Study Director: | Elizabeth Asztalos, MD, MSc | Sunnybrook & Women's College Health Sciences Centre |
| Study Director: | Chad Andersen, MD | Mercy Hospital for Women |
| Study Director: | Morris Blajchman, PhD | McMaster University |
| Study Director: | Nancy Heddle, MSc | McMaster University |
More Information
Publications:
| ClinicalTrials.gov Identifier: | NCT00182390 History of Changes |
| Other Study ID Numbers: | CTMG-2001-PINT, CIHR MCT-41549, CIHR MCT-58455 |
| Study First Received: | September 13, 2005 |
| Last Updated: | November 29, 2006 |
| Health Authority: | Canada: Health Canada |
Keywords provided by McMaster University:
|
ELBW premature infants neonatal transfusion bronchopulmonary dysplasia |
periventricular leukomalacia ventriculomegaly retinopathy of prematurity |
Additional relevant MeSH terms:
|
Anemia Anemia, Neonatal Infant, Premature, Diseases Hematologic Diseases Infant, Newborn, Diseases |
ClinicalTrials.gov processed this record on May 19, 2013