Delivery Room CPAP in Extremely Low Birth Weight Infants

NCT ID: NCT01223274

Last Updated: 2017-09-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-07-31

Study Completion Date

2003-01-31

Brief Summary

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This pilot study was designed to determine the feasibility of randomizing extremely low birth weight (ELBW) infants \<28 weeks' gestation who required resuscitation to one of two resuscitation methods, either: (a) 100% oxygen by facemask and continuous positive airway pressure (CPAP) or positive pressure ventilation (PPV) with positive end-expiratory pressure (PEEP), if the infant required PPV (the intervention group); or (b) 100% oxygen and no CPAP and no PEEP if the infant required PPV (the control group).

Detailed Description

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Previous studies suggested that early continuous airway positive pressure (CPAP) may be beneficial in reducing ventilator dependence and subsequent bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants. These studies did not test for the optimal timing of CPAP initiation or compare CPAP/PEEP initiation in the delivery room against standard resuscitation methods. Current practice at the time was for the ELBW infant to be intubated early and administered prophylactic surfactant. The feasibility of initiating CPAP in the DR and continuing this therapy without intubation for surfactant had not been determined prospectively in a population of ELBW infants.

This pilot study was designed to determine the feasibility of randomizing extremely low birth weight (ELBW) infants \<28 weeks' gestation who required resuscitation to one of two resuscitation methods, either: (a) 100% oxygen by facemask and continuous positive airway pressure (CPAP) or positive pressure ventilation (PPV) with positive end-expiratory pressure (PEEP), if the infant required PPV (the intervention group); or (b) 100% oxygen and no CPAP and no PEEP if the infant required PPV (the control group).

Conditions

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Infant, Newborn Infant, Low Birth Weight Infant, Small for Gestational Age Infant, Premature Bronchopulmonary Dysplasia Continuous Positive Airway Pressure

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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CPAP/PEEP Intervention

Infants received 100% oxygen by facemask and continuous positive airway pressure (CPAP) or positive pressure ventilation (PPV) with positive end-expiratory pressure (PEEP), if the infant required PPV.

Group Type EXPERIMENTAL

CPAP/PEEP

Intervention Type DEVICE

Infants received 100% oxygen by facemask and continuous positive airway pressure (CPAP) or positive pressure ventilation (PPV) with positive end-expiratory pressure (PEEP), if the infant required PPV.

Control

Control infants were treated with 100% oxygen and no CPAP. When a control infant required PPV, no PEEP was used.

Group Type ACTIVE_COMPARATOR

Standard management practices

Intervention Type DEVICE

Control infants were treated with 100% oxygen and no CPAP. When a control infant required PPV, no PEEP was used.

Interventions

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CPAP/PEEP

Infants received 100% oxygen by facemask and continuous positive airway pressure (CPAP) or positive pressure ventilation (PPV) with positive end-expiratory pressure (PEEP), if the infant required PPV.

Intervention Type DEVICE

Standard management practices

Control infants were treated with 100% oxygen and no CPAP. When a control infant required PPV, no PEEP was used.

Intervention Type DEVICE

Other Intervention Names

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Neopuff

Eligibility Criteria

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Inclusion Criteria

* Infants delivered in a specially equipped resuscitation room(s)
* \<28 weeks gestational age by best obstetric estimate before delivery
* Requiring resuscitation

Exclusion Criteria

* No known major congenital anomalies
* Decision made not to provide full resuscitation
Maximum Eligible Age

10 Minutes

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Center for Research Resources (NCRR)

NIH

Sponsor Role collaborator

NICHD Neonatal Research Network

NETWORK

Sponsor Role lead

Responsible Party

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University of California - San Diego

Principal Investigators

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Neil N. Finer, MD

Role: STUDY_DIRECTOR

University of California, San Diego

Avroy A. Fanaroff, MD

Role: PRINCIPAL_INVESTIGATOR

Case Western Reserve University, Rainbow Babies & Children's Hospital

Waldemar A. Carlo, MD

Role: PRINCIPAL_INVESTIGATOR

University of Alabama at Birmingham

Edward F. Donovan, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital Medical Center, Cincinnati

Charles R. Bauer, MD

Role: PRINCIPAL_INVESTIGATOR

University of Miami

W. Kenneth Poole, PhD

Role: PRINCIPAL_INVESTIGATOR

RTI International

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

University of California at San Diego

San Diego, California, United States

Site Status

University of Miami

Miami, Florida, United States

Site Status

RTI International

Durham, North Carolina, United States

Site Status

Cincinnati Children's Medical Center

Cincinnati, Ohio, United States

Site Status

Case Western Reserve University, Rainbow Babies and Children's Hospital

Cleveland, Ohio, United States

Site Status

Countries

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United States

References

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Finer NN, Carlo WA, Duara S, Fanaroff AA, Donovan EF, Wright LL, Kandefer S, Poole WK; National Institute of Child Health and Human Development Neonatal Research Network. Delivery room continuous positive airway pressure/positive end-expiratory pressure in extremely low birth weight infants: a feasibility trial. Pediatrics. 2004 Sep;114(3):651-7. doi: 10.1542/peds.2004-0394.

Reference Type RESULT
PMID: 15342835 (View on PubMed)

Related Links

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http://neonatal.rti.org/

NICHD Neonatal Research Network

Other Identifiers

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U10HD021364

Identifier Type: NIH

Identifier Source: secondary_id

View Link

M01RR000080

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U10HD034216

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U10HD027853

Identifier Type: NIH

Identifier Source: secondary_id

View Link

M01RR008084

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U10HD021397

Identifier Type: NIH

Identifier Source: secondary_id

View Link

M01RR016587

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U10HD040461

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U10HD036790

Identifier Type: NIH

Identifier Source: secondary_id

View Link

NICHD-NRN-0028

Identifier Type: -

Identifier Source: org_study_id