Comparison Between Preterm Infants Who Are Placed on Their Back or Stomach in the Immediate Postextubation Period

NCT ID: NCT02166645

Last Updated: 2014-06-18

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

94 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-31

Study Completion Date

2015-02-28

Brief Summary

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The purpose of this study is to determine whether patient positioning (prone and supine positioning) contributes to the success of extubation in the immediate postextubation period of preterm infants.

Detailed Description

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This study is double-blinded randomized controlled trial, whose aim is to compare the proportion of successful extubation of preterm infants immediately after the extubation. Methods: Participants will be recruited from neonatal intensive care unit (NICU) and they will be divided into two groups (supine and prone) and positioned in their respective groups after extubation. A clinical evaluation form and a parameters collection form (respiratory rate, heart rate, saturation of peripheral oxygen, fraction of inspired oxygen and temperature) will be used and filled before extubation and 48 hours after by the professional staff of the NICU. It will be considered a successful extubation all participants who staying extubated for 48 hours after extubation.

Conditions

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Pregnancy Preterm

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Prone position

Prone position per 48 hours after extubation

Group Type EXPERIMENTAL

Prone position

Intervention Type OTHER

Participants of intervention group will be placed in prone position immediately after extubation and positioned over a roll to raise the chest and facilitate diaphragmatic dynamic, with lateralized head and aligned with the trunk, upper and lower limbs flexed and hands near the face, facilitating hand-mouth access.

Supine position

Supine position per 48 hours after extubation

Group Type ACTIVE_COMPARATOR

Supine position

Intervention Type OTHER

Participants of control group remain in supine position after extubation and positioned with the head in the midline, with the upper side of the thorax and brought forward and rolls down the legs to promote slight flexion (30-40º) in the hips and knees.

Interventions

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Prone position

Participants of intervention group will be placed in prone position immediately after extubation and positioned over a roll to raise the chest and facilitate diaphragmatic dynamic, with lateralized head and aligned with the trunk, upper and lower limbs flexed and hands near the face, facilitating hand-mouth access.

Intervention Type OTHER

Supine position

Participants of control group remain in supine position after extubation and positioned with the head in the midline, with the upper side of the thorax and brought forward and rolls down the legs to promote slight flexion (30-40º) in the hips and knees.

Intervention Type OTHER

Other Intervention Names

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Ventral decubitus Dorsal decubitus

Eligibility Criteria

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Inclusion Criteria

* Newborns less than 37 weeks of gestation age (calculated by doctor using the method of Capurro/Ballard)
* Newborns undergone to invasive mechanical ventilation in the first week of life, for more than 48 hours

Exclusion Criteria

* Newborns who present malformations and clinical or surgical conditions that preclude the positioning in prone or supine after extubation
Maximum Eligible Age

36 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Uniao Metropolitana de Educacao e Cultura

OTHER

Sponsor Role lead

Responsible Party

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Maria Luiza Caires Comper

Master

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Maria Luiza Caíres Comper, Master

Role: PRINCIPAL_INVESTIGATOR

Uniao Metropolitana de Educacao e Cultura

Locations

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Manoel Novaes Hospital

Itabuna, Estado de Bahia, Brazil

Site Status RECRUITING

Countries

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Brazil

Facility Contacts

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Klênia Corrêa Solis Carrazza

Role: primary

55 73 3214-4300

References

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Antunes LC, Rugolo LM, Crocci AJ. [Effect of preterm infant position on weaning from mechanical ventilation]. J Pediatr (Rio J). 2003 May-Jun;79(3):239-44. Portuguese.

Reference Type BACKGROUND
PMID: 14506534 (View on PubMed)

Bhat RY, Hannam S, Pressler R, Rafferty GF, Peacock JL, Greenough A. Effect of prone and supine position on sleep, apneas, and arousal in preterm infants. Pediatrics. 2006 Jul;118(1):101-7. doi: 10.1542/peds.2005-1873.

Reference Type BACKGROUND
PMID: 16818554 (View on PubMed)

Jarus T, Bart O, Rabinovich G, Sadeh A, Bloch L, Dolfin T, Litmanovitz I. Effects of prone and supine positions on sleep state and stress responses in preterm infants. Infant Behav Dev. 2011 Apr;34(2):257-63. doi: 10.1016/j.infbeh.2010.12.014. Epub 2011 Mar 9.

Reference Type BACKGROUND
PMID: 21392826 (View on PubMed)

Oliveira TG, Rego MA, Pereira NC, Vaz LO, Franca DC, Vieira DS, Parreira VF. Prone position and reduced thoracoabdominal asynchrony in preterm newborns. J Pediatr (Rio J). 2009 Sep-Oct;85(5):443-8. doi: 10.2223/JPED.1932. English, Portuguese.

Reference Type BACKGROUND
PMID: 19830358 (View on PubMed)

Paiva KCA, Beppu OS. Posição prona. J Bras Pneumol. 2005;31(4):332-340.

Reference Type BACKGROUND

Richter T, Bellani G, Scott Harris R, Vidal Melo MF, Winkler T, Venegas JG, Musch G. Effect of prone position on regional shunt, aeration, and perfusion in experimental acute lung injury. Am J Respir Crit Care Med. 2005 Aug 15;172(4):480-7. doi: 10.1164/rccm.200501-004OC. Epub 2005 May 18.

Reference Type BACKGROUND
PMID: 15901611 (View on PubMed)

Sud S, Friedrich JO, Taccone P, Polli F, Adhikari NK, Latini R, Pesenti A, Guerin C, Mancebo J, Curley MA, Fernandez R, Chan MC, Beuret P, Voggenreiter G, Sud M, Tognoni G, Gattinoni L. Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med. 2010 Apr;36(4):585-99. doi: 10.1007/s00134-009-1748-1. Epub 2010 Feb 4.

Reference Type BACKGROUND
PMID: 20130832 (View on PubMed)

Other Identifiers

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NCT

Identifier Type: -

Identifier Source: org_study_id

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