The NEU-STIM Trial

NCT ID: NCT05942924

Last Updated: 2025-03-10

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

3280 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-11

Study Completion Date

2025-12-31

Brief Summary

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The aim of this study is to determine the effect of repetitive tactile stimulation compared to selective stimulation on oxygenation of the infant at 5 minutes after birth. Infants born before 32 weeks of gestation will be included in this trial. This is a stepped-wedge cluster randomised controlled trial. The participating centre, rather than the individual infant, will be the unit of randomisation. This design is appropriate to test the effect of an intervention that encompasses a behavioral aspect - in this case the performance of tactile stimulation.

Detailed Description

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Rationale: A randomised study demonstrated that preterm infants who received repetitive stimulation at birth (10 second episodes of stroking of the soles of the feet and/or back, followed by 10 seconds rest) showed an increase in respiratory effort. This may in turn improve clinical outcomes as improved breathing effort may reduce the need for invasive respiratory support. Tactile stimulation can be immediately and easily performed at birth at no extra cost. It therefore has great potential to be implemented in delivery rooms (DRs) worldwide.

Objective: To determine the effect of repetitive tactile stimulation compared to selective stimulation on oxygenation of the infant at 5 minutes after birth.

Study design: This is a stepped-wedge cluster randomised controlled trial. The participating centre, rather than the individual infant, will be the unit of randomisation. This design is appropriate to test the effect of an intervention that encompasses a behavioral aspect - in this case the performance of tactile stimulation.

Study population: Infants born before 32 weeks of gestation will be included in this trial.

Intervention: At the start of the study, each participating centre will perform selective tactile stimulation in accordance with international guidelines, as is their usual practice. Clinicians will gently rub the back, chest, extremities or soles of the feet if they consider the breathing of the infant to be insufficient or absent. In the second stage of the study, centres will be randomised to switch their stimulation approach to repetitive stimulation. Clinicians will then gently rub the back, chest, extremities or soles of the feet for 10 seconds. To avoid extinction of the stimulatory effect (reflex), every 10 second period of stimulation will be followed by 10 seconds of rest (no stimulation). Repetitive stimulation will be performed for the first 5 minutes of life, or longer if the breathing is still considered insufficient or absent.

Main study parameter: The proportion of infants with pre-ductal oxygen saturation (SpO2) ≥ 80%.

Conditions

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Infant, Premature, Diseases Birth, Preterm

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a stepped-wedge cluster randomised controlled trial. The participating centre, rather than the individual infant, will be the unit of randomisation.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Centres will be randomised for the fortnight at which they will switch their tactile stimulation practice from selective stimulation to repetitive stimulation. The analysing researcher will be blinded for the allocation of treatment switch.

Study Groups

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Selective stimulation

At the start of the study, selective tactile stimulation will be performed at each participating centre in accordance with international guidelines. Clinicians will gently rub the back, chest, extremities or soles of the feet if they consider the breathing of the infant to be insufficient or absent. All other procedures in the delivery room and NICU will be performed according to international and local guidelines.

Group Type ACTIVE_COMPARATOR

Selective tactile stimulation

Intervention Type PROCEDURE

See arm

Repeated stimulation

For each centre, a lot will be drawn which indicates the month in which the protocol for tactile stimulation changes from selective stimulation to repetitive stimulation.

Repetitive stimulation is defined as gently rubbing the soles of the feet, back, chest, or extremities for 10 seconds. To prevent extinction of the stimulatory effect (reflex), every 10 second period of stimulation will be followed by 10 seconds rest (no stimulation). The repetitive stimulation will be performed for the first 5 minutes after birth, or longer if the breathing is still considered insufficient or absent. All other procedures in the delivery room and NICU will be performed according to international and local guidelines.

Group Type EXPERIMENTAL

Repeated tactile stimulation

Intervention Type PROCEDURE

See arm

Interventions

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Repeated tactile stimulation

See arm

Intervention Type PROCEDURE

Selective tactile stimulation

See arm

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Infants born before 32 weeks of gestation can be included in this trial after parental consent.

Exclusion Criteria

* Infants will be excluded if they are found to have a congenital abnormality or condition that has an adverse effect on breathing/ventilation or oxygenation, including: congenital diaphragmatic hernia, trachea-oesophageal fistula, cyanotic heart disease and surfactant protein deficiency. Many of the infants enrolled in the study will later be diagnosed with respiratory distress syndrome (RDS); this will not render them ineligible for inclusion.
Maximum Eligible Age

32 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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European Society for Paediatric Research

UNKNOWN

Sponsor Role collaborator

Leiden University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Janneke Dekker

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Medical University of Graz

Graz, , Austria

Site Status RECRUITING

Liège University Hospital

Liège, , Belgium

Site Status RECRUITING

Clinical Hospital Center Rijeka

Rijeka, , Croatia

Site Status RECRUITING

Clinical Center Split

Split, , Croatia

Site Status RECRUITING

General Faculty Hospital in Prague

Prague, , Czechia

Site Status RECRUITING

Institute for Mother and Child Care

Prague, , Czechia

Site Status RECRUITING

Aarhus University Hospital

Aarhus, , Denmark

Site Status RECRUITING

Rigshospitalet Copenhagen

Copenhagen, , Denmark

Site Status RECRUITING

University Hospital Carl Gustav Carus

Dresden, , Germany

Site Status RECRUITING

University Hospital Dusseldorf

Düsseldorf, , Germany

Site Status RECRUITING

University Hospital Tubingen

Tübingen, , Germany

Site Status RECRUITING

Aristotle University of Thessaloniki

Thessaloniki, , Greece

Site Status RECRUITING

First dept of Obstetrics and Gynaecology, Semmelweis University

Budapest, , Hungary

Site Status RECRUITING

Second Semmelweis University

Budapest, , Hungary

Site Status RECRUITING

University of Debrecen

Debrecen, , Hungary

Site Status RECRUITING

Bács-Kiskun County Teaching Hospital

Szeged, , Hungary

Site Status RECRUITING

Landspitali University Hospital

Reykjavik, , Iceland

Site Status RECRUITING

National Maternity Hospital

Dublin, , Ireland

Site Status RECRUITING

Coombe Women & Infants University Hospital

Dublin, , Ireland

Site Status RECRUITING

University Hospital Galway

Galway, , Ireland

Site Status RECRUITING

Ospedale dei Bambini Vittore Buzzi

Milan, , Italy

Site Status RECRUITING

Leiden University Medical Center

Leiden, South Holland, Netherlands

Site Status RECRUITING

Erasmus MC Sophia Kinderziekenhuis

Rotterdam, , Netherlands

Site Status RECRUITING

Haukeland University Hospital

Bergen, , Norway

Site Status RECRUITING

Oslo University Hospital, Ulleval

Oslo, , Norway

Site Status RECRUITING

Oslo University Hospital

Oslo, , Norway

Site Status RECRUITING

Stavanger University Hospital

Stavanger, , Norway

Site Status RECRUITING

University Hospital of North Norway

Tromsø, , Norway

Site Status RECRUITING

St Olav's Hospital Trondheim

Trondheim, , Norway

Site Status RECRUITING

Jan Biziel University Hospital No. 2 in Bydgoszcz

Bydgoszcz, , Poland

Site Status RECRUITING

Medical University of Gdansk

Gdansk, , Poland

Site Status RECRUITING

Medical University of Silesa

Katowice, , Poland

Site Status RECRUITING

University of Medical Sciences

Poznan, , Poland

Site Status RECRUITING

Provincial Hospital

Rzeszów, , Poland

Site Status RECRUITING

Wrocław Medical University

Wroclaw, , Poland

Site Status RECRUITING

Hospital de Braga

Braga, , Portugal

Site Status RECRUITING

University Ovidius of Constanta

Constanța, , Romania

Site Status RECRUITING

Clinical County Emergency Hospital Sibiu

Sibiu, , Romania

Site Status RECRUITING

George Emil Palade University of Medicine

Târgu Mureş, , Romania

Site Status RECRUITING

La Fe University Hospital

Valencia, , Spain

Site Status NOT_YET_RECRUITING

University of Health Sciences Sancaktepe Ilhan Varank Training and Research Hospital, Istanbul

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Bukovyna State Medical University, Chernivtsi

Chernivtsi, , Ukraine

Site Status RECRUITING

Sumy State University

Sumy, , Ukraine

Site Status RECRUITING

Countries

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Austria Belgium Croatia Czechia Denmark Germany Greece Hungary Iceland Ireland Italy Netherlands Norway Poland Portugal Romania Spain Turkey (Türkiye) Ukraine

Central Contacts

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Janneke Dekker, PhD

Role: CONTACT

+31715266620

Colm O'Donnell, MD PhD

Role: CONTACT

+35316373100

Facility Contacts

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Nariae Baik-Schneditz, MD PhD

Role: primary

+433163850

Vincent Rigo

Role: primary

+32 4 323 00 00

Iva Bilic Cace, MD PhD

Role: primary

+38551658111

Anet Papazovska Cherepnalkovski

Role: primary

+385 21 556 111

Tereza Lamberska

Role: primary

+420 224 967 732

Milena Tuskova, MD

Role: primary

Ulla Christensen

Role: primary

+45 78 45 00 00

Christian Heiring

Role: primary

+45 35 45 35 45

Mario Ruediger

Role: primary

+49 351 4580

Janna-Lina Kerth

Role: primary

+49 211 8100

Laila Springer

Role: primary

+49 7071 290

Kosmas Sarafidis

Role: primary

+30 231 099 6000

Peter Varga

Role: primary

+36 1 266 0473

Zsuzsanna Nagy

Role: primary

+36 1 215 1380

Tamas Kovacs

Role: primary

+36 52 512 900

Gyula Talosi

Role: primary

+36 78 564 001

Sonja Baldursdottir

Role: primary

+354 543 1000

Colm O'Donnell, MD PhD

Role: primary

+35316373100

Jan Miletin

Role: primary

+353 1 408 5200

Johannes Letshwiti, MD

Role: primary

Francesco Cavigioli

Role: primary

+39 02 63631

Janneke Dekker, PhD

Role: primary

+31715266620

Ronny Knol

Role: primary

+31 10 704 0704

Hans J Guthe

Role: primary

Siv Fredly

Role: primary

+47 22 11 80 80

Anne L Solevag

Role: primary

+47 23 07 00 00

Peder Bjorland

Role: primary

+47 51 51 80 00

Claus Klingenberg

Role: primary

+47 77 62 60 00

Ragnhild Stoen

Role: primary

+47 72 57 30 00

Iwona Sadowska-Krawczenko

Role: primary

Joanna Jassem-Bobowicz, MD PhD

Role: primary

Iwona Maruniak-Chudek

Role: primary

+48 32 208 36 00

Tomasz Szczapa, MD PhD

Role: primary

Witold Blaz

Role: primary

+48 17 866 40 00

Barbara Krolak-Olejnik

Role: primary

+48 71 733 11 10

Almerinda Barroso Pereira

Role: primary

+351 253 027 000

Irina Franciuc

Role: primary

+40 241-605002

Maria Livia Ognean

Role: primary

+40 269-215-050

Manuela Cucerea

Role: primary

+40 265 262 275

Celia Barber Almenar

Role: primary

+34961244000

Tugce Goktas

Role: primary

+90 216 606 33 00

Anastasiya Babintseva

Role: primary

+380 372 553 754

Viktoriia Petrashenko

Role: primary

+380 542 334 058

References

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Dekker J, Hooper SB, Martherus T, Cramer SJE, van Geloven N, Te Pas AB. Repetitive versus standard tactile stimulation of preterm infants at birth - A randomized controlled trial. Resuscitation. 2018 Jun;127:37-43. doi: 10.1016/j.resuscitation.2018.03.030. Epub 2018 Mar 23.

Reference Type BACKGROUND
PMID: 29580959 (View on PubMed)

Related Links

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Other Identifiers

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N22.121

Identifier Type: -

Identifier Source: org_study_id

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