NIPPV Versus Bi-level Nasal Continuous Positive Airway Pressure Following Extubation

NCT ID: NCT02842190

Last Updated: 2019-10-04

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

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-15

Study Completion Date

2019-10-15

Brief Summary

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Mechanical ventilation is important in the care of preterm infants with respiratory failure, but may be associated with lung injury. Efforts are needed to avoid or minimize the use of mechanical ventilation. However, there is no consensus on the best non-invasive ventilation mode after extubation in preterm infants.

Objective: To compare the effectiveness of nasal intermittent positive pressure ventilation (NIPPV) versus bi-level nasal continuous positive airway pressure (BIPAP) following extubation in preterm infants ≤ 1250 g birthweight.

Detailed Description

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In this study , mechanically ventilated preterm infants with birthweight ≤1250 g will screen for eligibility. Infants with major congenital malformations, neuromuscular disease and lack of parental consent were excluded. Enrolled infants will randomize into two study groups (NIPPV group and BIPAP group) following the decision to extubate by using sealed opaque envelopes. Extubation criteria are; loaded with caffeine according to standard clinical protocol, satisfactory blood gases (pH of more than 7.25), mean airway pressure of 7 cm water or less, fractional inspired oxygen concentration of 35 % or less and good respiratory effort.

Non-invasive respiratory support will deliver using the device of SLE 5000 (Specialised Laboratory Equipment, South Croydon, United Kingdom) in NIPPV group and infant flow- deriver device (Viasys Corp, Care Fusion, CA) in BIPAP group. The short binasal prongs will use as interface. The initial ventilator parameters for NIPPV were: PIP levels set 2 cm H2O above the pre-extubation PIP, PEEP: 5 cm H2O, rate the same as was being given before extubation and for BiPAP were: lower CPAP levels 4 to 6 cmH2O (maximum 7 cmH2O) and higher CPAP levels 8 to 9 cmH2O (maximum 10 cmH2O), Thigh 0.5-0.6 second, and a pressure exchange rate of 20-30/ minute, with the lowest adjusted FiO2 to maintain an oxygen saturation of 90% to 95%.

Extubation failure was defined as: development of respiratory acidosis (blood gases with pH \< 7.2 and PaCO2\> 60 mmHg), or hypoxemia (blood gases with PaO2 \< 50 mmHg despite oxygen supplementation of 60 percent), or severe apnea requiring mask ventilation.

Surfactant requirement is goingto evaluate in all infants after NICU admission. Poractant alfa was administered if necessary.

The primary end-point, rate of extubation failure within 96 hours following first extubation, will compared between the groups. Short and long-term neonatal outcomes will also evaluate.

Conditions

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Intubation Complication PreTerm Birth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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NIPPV

NIPPV after ekstubation

Group Type ACTIVE_COMPARATOR

NIPPV

Intervention Type DEVICE

after ekstubation

BIPAP

BIPAP after ekstubation

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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NIPPV

after ekstubation

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Mechanically ventilated preterm infants with birthweight ≤1250 g

Exclusion Criteria

* Infants with major congenital malformations, neuromuscular disease and lack of parental consent
Minimum Eligible Age

1 Day

Maximum Eligible Age

14 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zekai Tahir Burak Women's Health Research and Education Hospital

OTHER

Sponsor Role lead

Responsible Party

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nilüfer okur

NEONATOLOGY

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Serife Suna Oguz

Role: STUDY_DIRECTOR

Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey. Recruiting

Nurdan Uras

Role: STUDY_CHAIR

Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey. Recruiting

Locations

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Zekai Tahir Burak Maternity Teaching hospital

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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NİLUFER OKUR, dr

Role: CONTACT

+905065360059

Mehmet Buyuktiryaki

Role: CONTACT

+903123065072

Facility Contacts

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Fatmanur Sari, Assosiace professor

Role: primary

References

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Okur N, Buyuktiryaki M, Sari FN, Dizdar EA, Oguz SS. Ventilator-delivered nasal intermittent positive pressure ventilation versus nasal biphasic positive airway pressure following extubation in infants </=1250 g birth weight: a randomized trial. J Matern Fetal Neonatal Med. 2022 Feb;35(4):752-758. doi: 10.1080/14767058.2020.1731462. Epub 2020 Feb 27.

Reference Type DERIVED
PMID: 32106721 (View on PubMed)

Other Identifiers

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NIPPV-2016

Identifier Type: -

Identifier Source: org_study_id

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