Post-Extubation Assessment of Clinical Stability in ELBW Infants

NCT ID: NCT06037083

Last Updated: 2024-11-14

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

Total Enrollment

20 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-10-29

Study Completion Date

2026-01-31

Brief Summary

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This is an observational, proof-of-concept, feasibility study that aims to evaluate the feasibility of a monitoring system that integrates clinical data, high-resolution waveforms from the bedside monitor, regional oxygenation (via cerebral and splanchnic near-infrared spectroscopy), and regional ventilation (via electrical impedance tomography) from 20 extremely low birth weight infants at high-risk of reintubation.

Detailed Description

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The primary aim of this proof-of-concept study is to evaluate the feasibility and acceptance of a monitoring system that integrates clinical data and biomedical signals from multiple modalities in a cohort of extremely preterm infants at high-risk of clinical instability on non-invasive respiratory support.

Secondary aims will be to longitudinally describe peripheral oxygen saturation, cerebral oxygen saturation, splanchnic oxygen saturation and regional lung ventilation in extremely low birth weight infants with or without reintubation during the 7 days post extubation.

The application of this multimodal monitoring approach using both clinical and physiological data during the postextubation period will help by making the assessment of clinical stability more comprehensive, more objective, more accurate, more standardized, and more reflective of important end-organ function. Thus, the proposed multimodal monitoring could lead to more informed decisions about reintubation and more individualized treatment plans during this critical period, hence potentially leading to better outcomes.

Conditions

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Extremely Low Birth Weight Infants

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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20 extremely low birth weight infants

In addition to the standard care, all participants will be monitored using an extra oxygen saturation probe, two near infrared spectroscopy sensors, and an electrical impedance tomography belt. Data will be continuously collected from extubation to 168 hours postextubation

Oxygen saturation probe

Intervention Type DEVICE

The high-accuracy oxygen saturation signal will be continuously acquired for 168 hours post extubation from a separate pulse oximeter (Radical-7®, Masimo ROOT platform, MasimoCorp, Irvine, LA).

Near infrared spectroscopy sensors

Intervention Type DEVICE

The cerebral and splanchnic regional oxygen saturation signals will be acquired continuously for 168h post extubation using two near infrared spectroscopy sensors (Masimo ROOT platform, MasimoCorp, Irvine, LA), one placed on the forehead for cerebral oxygenation and one on the abdomen (for splanchnic oxygenation).

Electrical impedance tomography

Intervention Type DEVICE

The regional lung ventilation will be measured using Electrical Impedance Tomography (TIMPEL, USA) at three time points:

* From 1 hour pre-extubation to 2 hours post extubation (total 3 hours)
* Between 24 and 48 hours post extubation (total 3 hours)
* Between 72 and 96 hours post extubation (total 3 hours)

Interventions

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Oxygen saturation probe

The high-accuracy oxygen saturation signal will be continuously acquired for 168 hours post extubation from a separate pulse oximeter (Radical-7®, Masimo ROOT platform, MasimoCorp, Irvine, LA).

Intervention Type DEVICE

Near infrared spectroscopy sensors

The cerebral and splanchnic regional oxygen saturation signals will be acquired continuously for 168h post extubation using two near infrared spectroscopy sensors (Masimo ROOT platform, MasimoCorp, Irvine, LA), one placed on the forehead for cerebral oxygenation and one on the abdomen (for splanchnic oxygenation).

Intervention Type DEVICE

Electrical impedance tomography

The regional lung ventilation will be measured using Electrical Impedance Tomography (TIMPEL, USA) at three time points:

* From 1 hour pre-extubation to 2 hours post extubation (total 3 hours)
* Between 24 and 48 hours post extubation (total 3 hours)
* Between 72 and 96 hours post extubation (total 3 hours)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Birth weight \< 1000g and gestational age \< 28+0 weeks,
* Received mechanical ventilation within the first 72h of life,
* Undergoing their first planned extubation within the first 6 weeks of life.

Exclusion Criteria

\- Congenital anomalies and congenital heart disorders.
Maximum Eligible Age

28 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Justine's Hospital

OTHER

Sponsor Role collaborator

McGill University Health Centre/Research Institute of the McGill University Health Centre

OTHER

Sponsor Role lead

Responsible Party

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Wissam Shalish

Assistant Professor of Pediatrics, McGill University Neonatologist, Montreal Children's Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Wissam Shalish, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

McGill University Health Center/Montreal Children's hospital

Locations

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Centre Hospitalier Universitaire Sainte-Justine

Montreal, Quebec, Canada

Site Status RECRUITING

McGill University Health Center

Montreal, Quebec, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Wissam Shalish, MD, PhD

Role: CONTACT

+1(514) 4124452 ext. 22341

Facility Contacts

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Sophie Tremblay, MD, FRCPC, MSc

Role: primary

1-514-345-4931 ext. 4500

Wissam Shalish, MD, PhD

Role: primary

514-412-4400 ext. 22341

Wissam Shalish, MD PhD

Role: backup

Guilherme Sant'Anna, MD PhD

Role: backup

Robert E Kearney, PhD

Role: backup

Other Identifiers

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2023-8794

Identifier Type: -

Identifier Source: org_study_id

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