Weaning of Nasal Continuous Positive Airway Pressure (CPAP) in Premature Infants

NCT ID: NCT01721629

Last Updated: 2017-05-01

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

380 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-09-30

Study Completion Date

2017-04-28

Brief Summary

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The aim of this study is to investigate two different strategies for the withdrawal of CPAP in preterm infants born before 32 weeks of gestation.

Detailed Description

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Conditions

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Prematurity Respiratory Distress Syndrome, Infant

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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Sudden wean of nasal CPAP

The CPAP is taken off at the morning ward round. If the discontinuation of the CPAP fails according to prespecified failure criteria, CPAP is recommenced and continued for at least 24 hours. Then a new evaluation takes place and if the infant again meets the inclusion criteria another attempt of sudden wean can be undertaken. Infants are considered successfully weaned if they are off CPAP for three days.

Group Type OTHER

Sudden wean of nasal CPAP

Intervention Type PROCEDURE

Gradual wean of nasal CPAP pressure

The reduction of the CPAP pressure begins at the morning ward round and the pressure is reduced in steps with 1 cmH2O maximum once a day. Each time the pressure is to be reduced the infant needs to be evaluated according to the inclusion criteria and only if these are still met, will the pressure be reduced. When a CPAP pressure at 4 cmH2O is reached the infant is treated with this pressure for 24 hours and then the CPAP is discontinued. Infants are considered successfully weaned if they are off CPAP for three days.

Group Type OTHER

Gradual wean of nasal CPAP

Intervention Type PROCEDURE

Interventions

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Sudden wean of nasal CPAP

Intervention Type PROCEDURE

Gradual wean of nasal CPAP

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Gestational age \< 32 weeks at birth
* Current gestational age \> 28+6 weeks
* Nasal CPAP for \> 24 hours
* Nasal CPAP pressure \< 8 cmH2O
* Oxygen requirement \< 30% and not increasing
* Respiratory rate \< 70 per minute
* Less than 3 episodes of oxygen saturation \< 70% or a heart rate \< 70 beat per minute in the preceding 24 hours
* Tolerates time off CPAP during cares (up to 15 minutes)

Exclusion Criteria

* Congenital malformations of the heart (except patent ductus arteriosus, atrial septal defect and patent foramen ovale), lung, and gastrointestinal tract
* Surgical procedures performed on the gastrointestinal tract
* Known or suspected to have congenital neuromuscular disease
* Known or suspected syndrome
Maximum Eligible Age

6 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aarhus University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Christina Friis Jensen

MD, Ph.D. student

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christina F Jensen, MD

Role: PRINCIPAL_INVESTIGATOR

The Perinatal Epidemiology Research Unit and Department of Paediatrics, Aarhus University Hospital

Tine B Henriksen, Professor

Role: STUDY_DIRECTOR

Department of Paediatrics, Aarhus University Hospital

Kirsten Wisborg, Centre Director, DMSc

Role: STUDY_CHAIR

Aarhus University Hospital, Head-Neuro Centre

Finn Ebbesen, Professor

Role: STUDY_CHAIR

Department of Paediatrics, Aalborg University Hospital

Anna S Sørensen, MD, Ph.D.

Role: STUDY_CHAIR

The Perinatal Epidemiology Research Unit and Department of Paediatrics, Aarhus University Hospital

Locations

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Aalborg University Hospital, Department of Pediatrics

Aalborg, DK, Denmark

Site Status

Aarhus University Hospital, Department of Pediatrics

Aarhus, DK, Denmark

Site Status

Herning Hospital, Department of Pediatrics

Herning, DK, Denmark

Site Status

Viborg Hospital, Department of Pediatrics

Viborg, DK, Denmark

Site Status

Vendsyssel Hospital, Department of Pediatrics

Hjørring, , Denmark

Site Status

Randers Hospital, Department of Pediatrics

Randers, , Denmark

Site Status

Countries

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Denmark

References

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Jensen CF, Sellmer A, Ebbesen F, Cipliene R, Johansen A, Hansen RM, Nielsen JP, Nikitina OH, Petersen JP, Henriksen TB. Sudden vs Pressure Wean From Nasal Continuous Positive Airway Pressure in Infants Born Before 32 Weeks of Gestation: A Randomized Clinical Trial. JAMA Pediatr. 2018 Sep 1;172(9):824-831. doi: 10.1001/jamapediatrics.2018.2074.

Reference Type DERIVED
PMID: 30039171 (View on PubMed)

Other Identifiers

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AAUH190280

Identifier Type: -

Identifier Source: org_study_id

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