Cerebral Oxygen Saturation Monitoring During Optimum Cord Management in Preterm Infants

NCT ID: NCT06526091

Last Updated: 2024-07-29

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

40 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-02-15

Study Completion Date

2024-10-01

Brief Summary

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This study will assess the feasibilty measuring cerebral oxygen saturations using a Near Infrared Spectroscopy (NIRS) monitor immediately after delivery of preterm infants. The investigators aim to evaluate the effects of optimum cord management on cerebral oxygenation in this cohort

Detailed Description

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Optimal cord management is defined by delaying clamping of the umbilical cord for 1 minute after delivery and is recommend in all neonates, regardless of gestational age. Transfusion of blood from placenta to baby in this minute enables smooth cardiovascular transition and stable cerebral perfusion. Preterm infants are at increased risk of haemodynamic instability and brain injury if the cord is clamped too early. It remains unclear what the optimum time is to clamp the cord in preterm infants, and it is likely different for each baby. Current monitoring of heart rate and peripheral oxygen saturations does not correlate well with oxygen delivery to the brain. Near infrared spectroscopy (NIRS) is a non-invasive method of measuring regional cerebral oxygenation saturations. NIRS may be a helpful monitoring tool to guide optimum timing of cord clamping in preterm infants.

This study aims to assess the feasibility of using the INVOS 5100 NIRS monitor immediately after delivery in preterm infants born before 34 weeks gestational age. The investigators aim to assess if they can generate meaningful data on brain oxygen levels in the first few minutes of life. The secondary objectives are to use this data to describe the changes in heart rate, peripheral oxygen and cerebral oxygen saturations during placental transfusion and cord clamping.

The investigators will use the INVOS device to measure cerebral oxygenation immediately after delivery, during placental transfusion and cord clamping. We will assess the feasibility of the INVOS device for this purpose. We will use the INVOS data and routinely collected data at delivery to evaluate the effect of optimum cord management on cerebral perfusion, heart rate and peripheral oxygen saturations.

Conditions

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Pre-Term

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Preterm infants

Preterm infants born at less than 34 completed weeks gestation

Cerebral NIRS monitoring at delivery

Intervention Type OTHER

Application of cerebral NIRS monitoring immediately after delivery and during optimum cord management

Interventions

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Cerebral NIRS monitoring at delivery

Application of cerebral NIRS monitoring immediately after delivery and during optimum cord management

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All babies eligible for optimum cord management born before 34 completed weeks gestational age
* Parental consent

Exclusion Criteria

* Multiple pregnancies
* Infants for whom resuscitation at birth is not appropriate
* Antenatal or immediate postnatal diagnosis of severe congenital anomaly
* Infants with complex congenital cardiac disease
Minimum Eligible Age

1 Minute

Maximum Eligible Age

24 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Imperial College Healthcare NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jayanta Banerjee, MD (Res)

Role: PRINCIPAL_INVESTIGATOR

Imperial College Healthcare NHS Trust

Locations

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Imperial College Healthcare NHS Trust

London, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Jayanta Banerjee, MD (Res)

Role: CONTACT

07771826045

Laura Edgar, MBBS

Role: CONTACT

07747034477

Facility Contacts

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Becky Ward

Role: primary

Other Identifiers

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22QC7933

Identifier Type: -

Identifier Source: org_study_id

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