Patient Comfort During High Flow Nasal Cannula Versus Nasal Continuous Airway Pressure (CPAP)

NCT ID: NCT01526226

Last Updated: 2017-06-26

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

NA

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-02-29

Study Completion Date

2013-05-31

Brief Summary

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Preterm children are at increased risk for developing lung disease due to immature lungs. Non-invasive ventilation (NIV) support is increasingly used as treatment. Nasal continuous positive airway pressure (nCPAP) is the most common NIV-mode. Recently, high flow nasal cannulas (HFNC) have become an alternative NIV-mode. Both nCPAP and HFNC provide increased pressure in the airways aiming to keep the lungs open. With nCPAP it is common to use short binasal prongs that fill the nostrils completely and are pressed tightly over the nose. With HFNC oxygen/air is administered via two small, thin cannulas located just inside the nostrils, but the nostrils are not blocked.

The aim of this study is to compare patient comfort in premature infants treated with nCPAP and HFNC. The investigators hypothesis is that HFNC increases patient comfort.

The study is a randomized cross over study (2 x 24 hours). Children eligible for inclusion should be born before 34 weeks of gestation and have moderate respiratory distress, thus be "in need" of nCPAP. During the study period (48 hours) the investigators will consider how the child tolerates treatment with nCPAP versus HFNC. Primary outcome is patient comfort assessed with the EDIN-score (Neonatal pain and comfort score). Secondary outcomes are stress hormone response (cortisol in saliva), surrounding noise and parental satisfaction. The child's breathing pattern will be carefully monitored. The study involves no extra painful investigations.

The investigators plan to recruit 20 patients.

Detailed Description

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Conditions

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Respiratory Distress Syndrome, Newborn Medical Device Discomfort

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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HFNC

High flow nasal cannula

Group Type EXPERIMENTAL

Respiratory support HFNC

Intervention Type DEVICE

In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP

Respiratory support NCPAP

Intervention Type DEVICE

In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP

nCPAP

Nasal CPAP

Group Type ACTIVE_COMPARATOR

Respiratory support HFNC

Intervention Type DEVICE

In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP

Respiratory support NCPAP

Intervention Type DEVICE

In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP

Interventions

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Respiratory support HFNC

In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP

Intervention Type DEVICE

Respiratory support NCPAP

In the cross over study 2 types of respiratory support are compared; HFNC versus nCPAP

Intervention Type DEVICE

Other Intervention Names

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HFNC; Fisher and Paykel NCPAP: Infant Flow (CareFusion)

Eligibility Criteria

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Inclusion Criteria

* Preterm infants admitted to the NICU at University Hospital of North Norway, Tromsoe, Norway (single center study)

* Gestational age (GA) \< 34 weeks
* Corrected age \< 34 weeks
* Receiving nasal CPAP for respiratory distress
* Respiratory "stable": FiO2 \< 30%, pCO2 \< 8,5 kPa and pH \> 7.25.
* GA \< 29 weeks: Respiratory "stable" over last 72 h.
* GA 29-33 weeks: Respiratory "stable" over last 24 h.

Exclusion Criteria

1. Congenital anomalies
2. Ongoing treatment for hypoglycemia or infection
3. Other intercurrent disease requiring frequent blood sampling
Minimum Eligible Age

25 Weeks

Maximum Eligible Age

34 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital of North Norway

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Claus Klingenberg, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital of North Norway, Tromsø, Norway

Locations

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University Hospital of North Norway

Tromsø, , Norway

Site Status

Countries

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Norway

References

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Wilkinson D, Andersen C, O'Donnell CP, De Paoli AG. High flow nasal cannula for respiratory support in preterm infants. Cochrane Database Syst Rev. 2011 May 11;(5):CD006405. doi: 10.1002/14651858.CD006405.pub2.

Reference Type BACKGROUND
PMID: 21563154 (View on PubMed)

Klingenberg C, Pettersen M, Hansen EA, Gustavsen LJ, Dahl IA, Leknessund A, Kaaresen PI, Nordhov M. Patient comfort during treatment with heated humidified high flow nasal cannulae versus nasal continuous positive airway pressure: a randomised cross-over trial. Arch Dis Child Fetal Neonatal Ed. 2014 Mar;99(2):F134-7. doi: 10.1136/archdischild-2013-304525. Epub 2013 Nov 13.

Reference Type DERIVED
PMID: 24225220 (View on PubMed)

Other Identifiers

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2011-2019 REK NORD

Identifier Type: -

Identifier Source: org_study_id

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