Study of the Effects of CPAP and HHHFNC on Diaphragmatic Dimensions in Preterm Infants

NCT ID: NCT02421328

Last Updated: 2017-03-13

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

2015-05-31

Study Completion Date

2016-10-31

Brief Summary

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This is a prospective, randomized crossover study to recognize the effects of nasal continuous positive airway pressure (CPAP) versus heated humidified high flow nasal cannula (HHHFNC) on diaphragmatic dimensions and excursion (evaluated by ultrasonography) in preterm infants.

Detailed Description

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Preterm infants will be recruited consecutively from NICU of Mansoura University Children's Hospital. They will be randomized in two groups; one group will start on nasal CPAP (Fisher \& Paykel Healthcare, Auckland, New Z ealand) (Pressure 5 cmH2O) for 60 minutes and then will be switched to HHHFNC (Fisher \& Paykel Healthcare, Auckland, New Z ealand) (flow of 4 l/m) for another 60 minutes. The other group will start on HHHFNC and then switched to nasal CPAP.

After the 2 h study period (2×60 minutes epochs) further respiratory support will be at the discretion of the clinical team.

Ultrasonographic assessment of diaphragmatic dimensions and excursion will be analyzed in different respiratory cycles and the average of 3 cycles will be calculated at the end of the 60 minutes periods on nasal CPAP and HHHFNC.

Conditions

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Respirtory Distress

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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CPAP first

Infant will be given nasal CPAP for 60 minutes and then put on HHHFNC for another 60 minutes. Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of the 60 minute periods on nasal CPAP and HHHFNC. After the 2 h study period (2×60 minutes epochs) further respiratory support will be at the discretion of the clinical team

Group Type ACTIVE_COMPARATOR

CPAP first (Fisher & Paykel Healthcare)

Intervention Type DEVICE

Infants will start on nasal CPAP for 60 minutes and then switched to HHHFNC for anther 60 minutes. Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of each 60 minute epochs.

HHHFNC first

Infant will be given HHHFNC for 60 minutes and then switched to nasal CPAP for another 30 minutes. Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of the 60 minute periods on HHHFNC and nasal CPAP. After the 2 h study period (2×60 minutes epochs) further respiratory support will be at the discretion of the clinical team

Group Type ACTIVE_COMPARATOR

HHHFNC first (Fisher & Paykel Healthcare)

Intervention Type DEVICE

Infants will start on HHHFNC for 60 minutes and then switched to nasal CPAP for anther 60 minutes. Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of each 60 minute epochs.

Interventions

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CPAP first (Fisher & Paykel Healthcare)

Infants will start on nasal CPAP for 60 minutes and then switched to HHHFNC for anther 60 minutes. Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of each 60 minute epochs.

Intervention Type DEVICE

HHHFNC first (Fisher & Paykel Healthcare)

Infants will start on HHHFNC for 60 minutes and then switched to nasal CPAP for anther 60 minutes. Ultrasonographic assessment of diaphragmatic dimensions and excursion will be done at the end of each 60 minute epochs.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Preterm infants \< 37 weeks.
* Stable on nasal continuous positive airway pressure (CPAP) for at least 24 hours.
* On less than 35% oxygen.

Exclusion Criteria

* Congenital and acquired problems of the gastrointestinal tract as necrotizing enterocolitis, esophageal perforation and tracheoesophageal fistula.
* Phrenic nerve injury and/or diaphragm paralysis
* Congenital/acquired neurological deficit and/or seizures
* Hemodynamic instability
* Congenital heart disease (including symptomatic patent ductus arteriosus)
* Undergoing treatment for sepsis or pneumonia.
* Use of muscle relaxants, narcotic analgesics, or gastric motility agents.
* Congenital anomalies of respiratory tract.
* Infants requiring more than 35% oxygen.
* Infants with facial anomalies.
* Infants with pneumothorax and/or pneumomediatinum.
* Infants in the immediate postoperative period.
* Infants with significant gastric residues and vomiting.
Maximum Eligible Age

1 Month

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mansoura University Children Hospital

OTHER

Sponsor Role lead

Responsible Party

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Hesham Abdel-Hady

Professor of Pediatrics

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Neonatal Intensive Care Unit, Mansoura University Children Hospital

Al Mansurah, Dakahlia Governorate, Egypt

Site Status

NICU, Mansoura University Children's Hospital

Al Mansurah, Dakahlia Governorate, Egypt

Site Status

Countries

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Egypt

References

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El-Mogy M, El-Halaby H, Attia G, Abdel-Hady H. Comparative Study of the Effects of Continuous Positive Airway Pressure and Nasal High-Flow Therapy on Diaphragmatic Dimensions in Preterm Infants. Am J Perinatol. 2018 Apr;35(5):448-454. doi: 10.1055/s-0037-1608682. Epub 2017 Nov 13.

Reference Type DERIVED
PMID: 29132179 (View on PubMed)

Other Identifiers

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MS 874

Identifier Type: -

Identifier Source: org_study_id

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