Optimizing Tracheal Intubation Outcomes and Neonatal Safety

NCT ID: NCT05838690

Last Updated: 2025-06-12

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

3000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-01

Study Completion Date

2027-06-30

Brief Summary

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The purpose of the study is to assess the impact of a personalized intubation planning tool, the Personalized INtubation Safety (PINS) Bundle on intubation procedural safety and clinical outcomes among patients intubated in the neonatal intensive care unit (NICU) setting.

Detailed Description

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Tracheal intubation (TI) in the neonatal intensive care unit (NICU) is frequently complicated by adverse safety outcomes such as adverse tracheal intubation associated events, multiple TI attempts, and oxygen desaturation. Investigators have developed, refined, and tested a Personalized INtubation Safety (PINS) Bundle that targets a prospective and individualized approach to TI planning and management. The Prospective Intubation Safety (PINS) Bundle addresses 5 core evidence-based domains that are individualized to the patient to develop a prospective, personalized and comprehensive multidisciplinary TI plan: (1) patient risk assessment; (2) treatment threshold for intubation; (3) premedication (promoting paralytic medication); (4) equipment (promoting video laryngoscope); (5) provider selection and escalation plan.

This is a pragmatic stepped wedge cluster randomized trial of NICU patients who are intubated across 8 participating hospitals to determine if the PINS Bundle, compared to no PINS Bundle, reduces the incidence of adverse tracheal intubation associated events.

The primary objective of this study is to determine the effectiveness of the PINS Bundle to decrease adverse TI safety events. The secondary objectives are 1) to evaluate if the impact of the PINS Bundle on adverse TI safety events varies based on provider skill, and 2) to determine the impact of the PINS Bundle on NICU clinical outcomes of extubation failure, duration of intubation, NICU mortality, and intraventricular hemorrhage.

Conditions

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Infant Intubation Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Pre-Intervention Phase

NICU Patients who are intubated without the PINS Bundle.

Group Type NO_INTERVENTION

No interventions assigned to this group

Post-intervention Phase

NICU Patients who are intubated after unit implementation of the PINS Bundle

Group Type ACTIVE_COMPARATOR

Personalized Intubation Safety (PINS) Bundle

Intervention Type OTHER

The Personalized Intubation Safety (PINS) Bundle addresses 5 core domains that are individualized to the patient to develop a prospective, personalized and comprehensive multidisciplinary intubation plan: (1) patient risk assessment; (2) treatment threshold for intubation; (3) premedication (promoting paralytic premedication); (4) equipment (promoting video laryngoscope); (5) provider selection and escalation plan

Interventions

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Personalized Intubation Safety (PINS) Bundle

The Personalized Intubation Safety (PINS) Bundle addresses 5 core domains that are individualized to the patient to develop a prospective, personalized and comprehensive multidisciplinary intubation plan: (1) patient risk assessment; (2) treatment threshold for intubation; (3) premedication (promoting paralytic premedication); (4) equipment (promoting video laryngoscope); (5) provider selection and escalation plan

Intervention Type OTHER

Other Intervention Names

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PINS Bundle

Eligibility Criteria

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Inclusion Criteria

Infants undergoing tracheal intubation in the neonatal intensive care unit (NICU)

Exclusion Criteria

Endotracheal tube exchanges, as this represents a distinct procedure.
Maximum Eligible Age

1 Year

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Children's Hospital of Philadelphia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elizabeth Foglia, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital of Philadelphia

Locations

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University of Arkansas Medical Sciences

Little Rock, Arkansas, United States

Site Status RECRUITING

University of Colorado - Denver

Denver, Colorado, United States

Site Status RECRUITING

Yale-New Haven Hospital

New Haven, Connecticut, United States

Site Status RECRUITING

Dartmouth-Hitchcock Clinic

Lebanon, New Hampshire, United States

Site Status RECRUITING

WakeMed Health & Hospitals

Raleigh, North Carolina, United States

Site Status RECRUITING

Penn State Milton S. Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status RECRUITING

University of Washington

Seattle, Washington, United States

Site Status RECRUITING

CHU Sainte-Justine

Montreal, Quebec, Canada

Site Status ACTIVE_NOT_RECRUITING

Countries

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United States Canada

Central Contacts

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Elizabeth Foglia, MD

Role: CONTACT

215-590-1000

Hayley Buffman, MPH

Role: CONTACT

215-590-1000

Facility Contacts

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Shuk-Mei Ho, MD

Role: primary

501-686-5391

Deborah Barnard

Role: primary

303-724-7628

Monika Lau, MEd

Role: primary

203-737-4434

Kelly Stevens

Role: primary

207-415-7180

Catherine Kilday

Role: primary

919-350-7335

Rafael Santos, MS, CIP

Role: primary

814-865-4295

Johanna Salmonson

Role: primary

206-543-4464

Other Identifiers

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R01HD106996

Identifier Type: NIH

Identifier Source: secondary_id

View Link

22-019975

Identifier Type: -

Identifier Source: org_study_id

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