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Sponsored by: |
Hamilton Health Sciences |
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Information provided by: | McMaster University |
ClinicalTrials.gov Identifier: | NCT00636324 |
Despite widely used of nasal CPAP in preterm infants, uncertainties regarding aspects of its application remain. Clinical indications vary greatly between institutions, especially when combined with varieties of systems, devices, and techniques available. One of the controversial aspects that needs to be clarified is the level of pressure which should be used. The objective of the study is to compare the effectiveness of two ranges of nCPAP pressure that are within the spectrum of current practice for post-extubation support in very preterm infants.
Condition | Intervention | Phase |
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Respiratory Insufficiency of Prematurity |
Device: Nasal CPAP, level 7 to 9 cmH2O Device: Nasal CPAP, level 4 to 6 cmH2O |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study |
Official Title: | Nasal Continuous Positive Airway Pressure in Preterm Infants After Extubation: Comparison of Different Levels of Pressure |
Estimated Enrollment: | 180 |
Study Start Date: | July 2007 |
Estimated Study Completion Date: | June 2010 |
Primary Completion Date: | March 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Experimental
Nasal CPAP, level of 7 to 9 cmH2O
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Device: Nasal CPAP, level 7 to 9 cmH2O
Apply nasal CPAP pressure of 7-9 H2O for the first 72 hours of extubation
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2: Active Comparator
Nasal CPAP, level 4 to 6 cmH2O
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Device: Nasal CPAP, level 4 to 6 cmH2O
Apply nasal CPAP pressure of 4 to 6 cmH2O for the first 72 hours of extubation
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The use of nCPAP has been established as an effective respiratory support to prevent extubation failure and as treatment of other pulmonary diseases. An upsurge in its popularity has resulted in some controversial aspects, including the level of pressure to be used. The level that has been used in very preterm infants after extubation, which mostly came from anecdotal data, varies from 3 to 10 cmH2O.
Physiologic studies show higher nCPAP pressures improve lung mechanical properties. Though potential side effects have been of concern in practical application, there is no formal evidence supporting the concept that increased CPAP pressure results in a higher risk of complications. In relatively stable preterm infants, the range of optimal CPAP level needs to be established in order to adequately support the upper airway and lungs, without increasing complications secondary to the pressure applied. Given the uncertainty of the nCPAP pressure that should be used in very preterm infants, we conduct a randomized controlled trial to compare the effectiveness of two ranges of nCPAP pressure for post-extubation support in very preterm infants.
The purpose of this trial is to compare the rate of successful extubation of using the nasal CPAP level of 7 to 9 cmH2O compared to level of 4 to 6 cmH2O.
Ages Eligible for Study: | up to 14 Days |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Guilherme M SantAnna, MD | 905 521 2100 ext 76487 | santang@mcmaster.ca |
Contact: Ratchada Kitsommart, MD | 905 521 2100 ext 75612 | rkitsommart@hotmail.com |
Canada, Ontario | |
Division of Neonatology, Hamilton Health Sciences | Recruiting |
Hamilton, Ontario, Canada, L8P 3Z5 | |
Contact: Guilherme M SantAnna, MD 905 521 2100 ext 76487 santang@mcmaster.ca | |
Contact: Ratchada Kitsommart, MD 905 521 2100 ext 75612 rkitsommart@hotmail.com |
Principal Investigator: | Giulherme M SantAnna, MD | Hamilton Health Sciences |
Responsible Party: | Hamilton Health Sciences ( Guilherme Mendes Sant'Anna ) |
Study ID Numbers: | REB project # 07-047 |
Study First Received: | March 7, 2008 |
Last Updated: | March 13, 2008 |
ClinicalTrials.gov Identifier: | NCT00636324 |
Health Authority: | Canada: Ethics Review Committee |
Respiratory distress syndrome Preterm infants Extubation failure |
Pneumothorax Lung injury Airway pressure |
Respiratory Insufficiency Respiratory Tract Diseases Respiration Disorders Pneumothorax |