Newborn Ventilation in the Delivery Room: Could it be Improved With a T-piece Resuscitator?

NCT ID: NCT00443118

Last Updated: 2018-09-28

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1032 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-12-31

Study Completion Date

2012-08-31

Brief Summary

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A multicenter cross-over cluster randomized controlled trial protocol study in newborn infants ≥ 26 weeks gestational age requiring assisted ventilation (positive pressure ventilation \[PPV\]) for resuscitation in the delivery room comparing a T-piece resuscitator device versus resuscitation bag.

Detailed Description

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Design: A multicenter cross-over cluster randomized controlled trial. Our hypothesis is based on the assumption that ventilating depressed newborns with a T-piece resuscitator will be more effective than SIB by increasing the proportion of resuscitated newborns with heart rate (HR) ≥ 100 beats per minute (bpm) at two minutes of life as a proxy for successful resuscitation.

Population: Newborn infants ≥ 26 weeks gestational age requiring assisted ventilation (PPV) for resuscitation in the delivery room.

(need for assisted ventilation at positive pressure: Heart Rate \[HR\] \< 100 beats per minute \[bpm\], apnea, gasping, cyanosis and/or hypotonia)

Intervention: PPV will be performed with a T-piece resuscitator (Neopuff® group) with positive end expiratory pressure.

Control: PPV will be performed with a self inflating bag (SIB group) with and without PEEP.

Both devices will be used with face masks, and a peak inspiratory pressure (PIP) of 25 cm H2O will be used to begin ventilation with PEEP of 0 cm H2O in the subgroup without PEEP valve, 5 cm H2O in the subgroup with PEEP valve in the SIB group, and 5 cm H2O in the Neopuff® group.

Objective: To compare the effectiveness of both instruments in reaching a heart rate of ≥ 100 bpm in depressed newborns of ≥ 26 weeks' gestational age (GA) after the initiation of positive pressure ventilation (PPV) with face mask.

Primary Outcome: Proportion of newborns with HR ≥ 100 bpm at 2 minutes of life.

Type of Comparison: Which of the two devices Neopuff TM or Self Inflating Bag (NP/SIB)will be more effective for ventilation of the newborn, by increasing the proportion of resuscitated newborns with heart rate (HR) ≥ 100 beats per minute (bpm) at two minutes of life as a proxy for successful resuscitation.

Conditions

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Resuscitation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Neopuff TM with PEEP

Newborns ventilated for neonatal resuscitation using Neopuff TM with PEEP

Group Type ACTIVE_COMPARATOR

T-piece resuscitator Neopuff TM

Intervention Type DEVICE

Positive pressure ventilation will be performed with Neopuff® with face mask. For this study, an initial PIP 25 cm H2O and a 5 cm H2O PEEP will be used for resuscitation according to protocol.

Self Inflating Bag with PEEP

Newborns ventilated for neonatal resuscitation using Self Inflating Bag with PEEP valve attached

Group Type ACTIVE_COMPARATOR

Self Inflating Bag with PEEP

Intervention Type DEVICE

Positive pressure ventilation will be performed with Self Inflating Bag with PEEP with face mask. For this study, an initial PIP 25 cm H2O and a 5 cm H2O PEEP will be used for resuscitation according to protocol.

Self Inflating Bag without PEEP

Newborns ventilated for neonatal resuscitationusing Self Inflating Bag without PEEP valve attached

Group Type ACTIVE_COMPARATOR

Self Inflating Bag without PEEP

Intervention Type DEVICE

Positive pressure ventilation will be performed with Self Inflating Bag without PEEP with face mask. For this study, an initial PIP 25 cm H2O and a 5 cm H2O PEEP will be used for resuscitation according to protocol.

Interventions

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T-piece resuscitator Neopuff TM

Positive pressure ventilation will be performed with Neopuff® with face mask. For this study, an initial PIP 25 cm H2O and a 5 cm H2O PEEP will be used for resuscitation according to protocol.

Intervention Type DEVICE

Self Inflating Bag with PEEP

Positive pressure ventilation will be performed with Self Inflating Bag with PEEP with face mask. For this study, an initial PIP 25 cm H2O and a 5 cm H2O PEEP will be used for resuscitation according to protocol.

Intervention Type DEVICE

Self Inflating Bag without PEEP

Positive pressure ventilation will be performed with Self Inflating Bag without PEEP with face mask. For this study, an initial PIP 25 cm H2O and a 5 cm H2O PEEP will be used for resuscitation according to protocol.

Intervention Type DEVICE

Other Intervention Names

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Ambu Ambu

Eligibility Criteria

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Inclusion Criteria

Live-born infants of ≥ 26 weeks' GA with HR \< 100 bpm requiring resuscitation with positive pressure ventilation with mask in the delivery room according to the current AAP/AHA recommendations

Exclusion Criteria

Infants requiring intubation from birth. Newborns of \< 26 weeks´ GA. Newborns presenting major congenital malformations. Multiple births. Problems (difficulty or malfunctioning) with the device assigned.
Maximum Eligible Age

2 Minutes

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Alabama at Birmingham

OTHER

Sponsor Role collaborator

Edgardo Szyld

OTHER

Sponsor Role lead

Responsible Party

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Edgardo Szyld

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Edgardo Szyld, MD

Role: PRINCIPAL_INVESTIGATOR

Fundasamin

Adriana Aguilar, MD

Role: STUDY_DIRECTOR

Hospital Paroissien

Waldemar Carlo, MD

Role: STUDY_CHAIR

University of Alabama at Birmingham

Nestor Vain, MD

Role: STUDY_DIRECTOR

Sanatorio de la Trinidad

Luis Prudent, MD

Role: STUDY_DIRECTOR

Sanatorio Otamendi

Locations

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Carol Jo Vecchie Women and Children's Center at St. John's Hospital

Springfield, Illinois, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Sanatorio de los Arcos

Ciudad de Buenos Aires, Buenos Aires, Argentina

Site Status

Hospital Universitario Austral

Pilar, Buenos Aires, Argentina

Site Status

Hospital Misericordia

Córdoba, , Argentina

Site Status

Nuevo Hospital El Milagro de Salta

Salta, , Argentina

Site Status

Hospital Clínico de la Pontificia Universidad Católica de Chile

Santiago, , Chile

Site Status

Hospital Dr. Hernán Henriquez Aravena

Temuco, , Chile

Site Status

Hospital Dr. Gustavo Fricke

Viña del Mar, , Chile

Site Status

Azienda Ospedaliera Padova

Padua, Veneto, Italy

Site Status

Instituto Nacional Materno Perinatal (INMP) de Perú

Lima, , Peru

Site Status

Countries

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United States Argentina Chile Italy Peru

References

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Szyld E, Aguilar A, Musante GA, Vain N, Prudent L, Fabres J, Carlo WA; Delivery Room Ventilation Devices Trial Group. Comparison of devices for newborn ventilation in the delivery room. J Pediatr. 2014 Aug;165(2):234-239.e3. doi: 10.1016/j.jpeds.2014.02.035. Epub 2014 Mar 29.

Reference Type DERIVED
PMID: 24690329 (View on PubMed)

Related Links

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http://www.ncbi.nlm.nih.gov/pubmed/24690329

this paper was published on The Journal of Pediatrics

Other Identifiers

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Fundasamin 102

Identifier Type: -

Identifier Source: org_study_id

NCT01126489

Identifier Type: -

Identifier Source: nct_alias

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