Randomized Trial of Nasal Continuous Positive Airway Pressure or Synchronized Nasal Ventilation in Premature Infants.
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ClinicalTrials.gov Identifier: NCT00188968 |
Recruitment Status
:
Completed
First Posted
: September 16, 2005
Last Update Posted
: May 2, 2007
|
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Apnea Infant, Premature Bronchopulmonary Dysplasia | Procedure: Nasal Continuous Positive Airway Pressure Procedure: Synchronized Nasal Positive Pressure Ventilation | Phase 3 |
Early extubation of premature infants may limit the deleterious effects of positive pressure ventilation. The primary cause of failure of extubation (and the need for reintubation) is apnea of prematurity. Standard treatment for improving extubation success and decreasing apnea of prematurity is with the use of nasal continuous positive airway pressure (nCPAP), use of methylxanthines, or both. Recent literature suggests that methylxanthines may have significant effect on long-term neurodevelopmental outcome.
This primary objective of this study is to investigate the effect of synchronized nasal intermittent positive pressure ventilation (sNIPPV) combined with standard nasal continuous positive airway pressure (nCPAP) versus standard nCPAP alone, on the need for reintubation and the need of methylxanthine therapy in premature infants. The study period for the primary objective will be the first 7 days immediately after the initial extubation of premature infants with birth weights 500-1250 grams. A secondary objective is to identify any differences in duration of time free of endotracheal intubation and duration of time free of methylxanthine use between the two treatment modalities as measured from the first extubation attempt.
The study is a randomized, controlled trial using a new CPAP machine (Infant Flow advance™) that will be able to provide nCPAP with and without sNIPPV. Because of the mechanics of the sNIPPV mode, blinding of the study is not possible. The study is pragmatic in design allowing the medical staff to make clinical decisions on ventilatory management based on the routinely used criteria thus evaluating the study interventions in the everyday clinical environment. Analysis will be on an intention-to-treat basis.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 48 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Randomized, Controlled Trial of Synchronized Nasal Intermittent Positive Pressure Ventilation Versus Nasal Continuous Positive Airway Pressure Using the Infant Flow Advance to Facilitate Successful Extubation in Premature Infants. |
Study Start Date : | November 2004 |
Actual Study Completion Date : | February 2007 |
- Need for methylxanthine treatment OR the need for re-intubation in the first 7 days after the initial extubation in preterm infants intubated for treatment of respiratory distress. [ Time Frame: 7 days immediately after first extubation attempt ]
- Duration of time to methylxanthine treatment. [ Time Frame: During first 7 days and during hospitalization ]
- Duration of supplemental oxygen use [ Time Frame: During hospitalization ]
- Incidence of bronchopulmonary dysplasia (both 28 days of age, and 36 weeks PCA) [ Time Frame: 28 days of age, 36 weeks PCA ]
- Frequency of apneas during the initial 7 days post-extubation. [ Time Frame: Initial 7 days post-extubation ]
- Complications of therapy (air leak syndromes, gastric and intestinal distension). [ Time Frame: During Hospitalization ]

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Ages Eligible for Study: | Child, Adult, Senior |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Premature infants with birth weight 500-1250 grams
- first attempt at extubation
Exclusion Criteria:(clinical suspicion or documented diagnosis of:
- neuromuscular disease
- chromosomal abnormality
- or any congenital anomalies that would affect ability to be extubated from mechanical ventilation via endotracheal tube (i.e. congenital cardiac anomalies, choanal atresia).

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00188968
Canada, Manitoba | |
Health Sciences Centre | |
Winnipeg, Manitoba, Canada, R3A 1R9 | |
St. Boniface General Hospital | |
Winnipeg, Manitoba, Canada |
Principal Investigator: | Aaron Chiu, MD | University of Manitoba | |
Principal Investigator: | Ruben Alvaro, MD | University of Mantioba |
ClinicalTrials.gov Identifier: | NCT00188968 History of Changes |
Other Study ID Numbers: |
B2004:172 |
First Posted: | September 16, 2005 Key Record Dates |
Last Update Posted: | May 2, 2007 |
Last Verified: | April 2007 |
Keywords provided by University of Manitoba:
Xanthines Reintubation Nasal Intermittent Ventilation Nasal continous positive airway pressure |
Additional relevant MeSH terms:
Premature Birth Bronchopulmonary Dysplasia Obstetric Labor, Premature Obstetric Labor Complications Pregnancy Complications Ventilator-Induced Lung Injury |
Lung Injury Lung Diseases Respiratory Tract Diseases Infant, Premature, Diseases Infant, Newborn, Diseases |