High Frequency Oscillatory Ventilation Versus High Frequency Jet Ventilation for Congenital Diaphragmatic Hernia

NCT ID: NCT04774848

Last Updated: 2025-04-04

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

RECRUITING

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-30

Study Completion Date

2025-08-28

Brief Summary

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The purpose of this study is to conduct a prospective study of all congenital diaphragmatic hernia (CDH) neonates managed at the University of Utah newborn intensive care unit (NICU) and Primary Children's Hospital NICU that required mechanical ventilation at birth. As both high frequency jet ventilation (HFJV) and high frequency oscillatory ventilation (HFOV) are standard approaches to ventilatory support of all neonates including CDH, CDH infants will be randomized at the time of birth or admission to either HFJV or HFOV as initial ventilator mode, stratified by position of the liver in the abdomen or thorax (if known) by 24 hours of age. Measures of oxygenation, ventilation and hemodynamics of the CDH cohort managed on HFOV compared to those on HFJV.

Detailed Description

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Conditions

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Congenital Diaphragmatic Hernia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Infants stratified by presence of intrathoracic liver (yes/no) and are randomized to either high frequency jet ventilator or high frequency oscillating ventilator in a sequential 1:1 manner
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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High Frequency Jet Ventilation (HFJV) with intrathoracic liver

Babies known to have the presence of the liver in the intrathoracic space will be placed on the HFJV at delivery or as soon as possible after consent. During analysis, these babies will be compared to babies with intrathoracic liver and randomized to high frequency oscillating ventilator.

Group Type ACTIVE_COMPARATOR

High Frequency Jet Ventilator

Intervention Type DEVICE

HFJV provides short bursts of gas into the respiratory circuit at a rate of 240 to 600/min (4 to 11 Hz) and expiration is passive. It is used in conjunction with a conventional ventilator which provides positive end expiratory pressure (PEEP) and can also provide occasional sigh breaths.

High Frequency Jet Ventilation (HFJV) without intrathoracic liver

Babies who do not have any liver in the intrathoracic space will be placed on the HFJV at delivery or as soon as possible after consent. During analysis, these babies will be compared to babies without intrathoracic liver and randomized to high frequency oscillating ventilator.

Group Type ACTIVE_COMPARATOR

High Frequency Jet Ventilator

Intervention Type DEVICE

HFJV provides short bursts of gas into the respiratory circuit at a rate of 240 to 600/min (4 to 11 Hz) and expiration is passive. It is used in conjunction with a conventional ventilator which provides positive end expiratory pressure (PEEP) and can also provide occasional sigh breaths.

High Frequency Oscillatory Ventilation (HFOV) with intrathoracic liver

Babies known to have the presence of the liver in the intrathoracic space will be placed on the HFOV at delivery or as soon as possible after consent. During analysis, these babies will be compared to babies with intrathoracic liver and randomized to HFJV.

Group Type ACTIVE_COMPARATOR

High Frequency Oscillatory Ventilator

Intervention Type DEVICE

HFOV uses a piston diaphragm to generate alternating positive and negative pressure changes to give breaths of 300 to 900/min (5-15 Hz) given over a set mean airway pressure. Both inhalation and exhalation are active.

High Frequency Oscillatory Ventilation (HFOV) without intrathoracic liver

Babies who do not have any liver in the intrathoracic space will be placed on the HFOV at delivery or as soon as possible after consent. During analysis, these babies will be compared to babies without intrathoracic liver and randomized to HFJV.

Group Type ACTIVE_COMPARATOR

High Frequency Oscillatory Ventilator

Intervention Type DEVICE

HFOV uses a piston diaphragm to generate alternating positive and negative pressure changes to give breaths of 300 to 900/min (5-15 Hz) given over a set mean airway pressure. Both inhalation and exhalation are active.

Interventions

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High Frequency Jet Ventilator

HFJV provides short bursts of gas into the respiratory circuit at a rate of 240 to 600/min (4 to 11 Hz) and expiration is passive. It is used in conjunction with a conventional ventilator which provides positive end expiratory pressure (PEEP) and can also provide occasional sigh breaths.

Intervention Type DEVICE

High Frequency Oscillatory Ventilator

HFOV uses a piston diaphragm to generate alternating positive and negative pressure changes to give breaths of 300 to 900/min (5-15 Hz) given over a set mean airway pressure. Both inhalation and exhalation are active.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Admitted to either the University of Utah and/or Primary Children's Hospital NICU within 24 hours of birth
2. Requiring mechanical ventilation
3. Umbilical arterial line or peripheral arterial line in place
4. Obtained signed consent
5. Infant is ≤ 24 hours of age

Exclusion Criteria

1. Severe anomaly

1. Chromosomal abnormalities
2. Major congenital anomalies, including cardiac, central nervous system and syndromes
2. Post-natal diagnosis \> 24 hours of life
3. Unable to obtain consent for participation
4. Unable to randomize within 24 hours of life
Maximum Eligible Age

24 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Michelle Yang

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michelle Yang, MD

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Locations

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Primary Children's Hospital

Salt Lake City, Utah, United States

Site Status RECRUITING

University Hospital

Salt Lake City, Utah, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Michelle Yang, MD

Role: CONTACT

801-581-7052

Carrie Rau

Role: CONTACT

801-213-3360

Facility Contacts

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Michelle Yang, MD

Role: primary

801-581-7052

Kimberlee Weaver-Lewis, RN

Role: backup

801-507-7675

Michelle Yang, MD

Role: primary

801-581-7052

Carrie Rau, RN

Role: backup

801-213-3360

Other Identifiers

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133683

Identifier Type: -

Identifier Source: org_study_id

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