Prospective Multicentre Mixed Methods Study to Explore Extubation Practices and Respiratory Outcomes in Extremely Preterm Neonates.

NCT ID: NCT06808997

Last Updated: 2025-12-10

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-02-17

Study Completion Date

2026-04-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this observational study is to learn about neonatologists' perceptions of extubation readiness and extubation and reintubation practices in extremely preterm infants in the first 2 weeks of life using prospective qualitative and quantitative data. Actual extubation readiness is defined as successful extubation, defined as no reintubation in the 7 days following extubation.

Key research questions are: How do clinicians assess extubation readiness in this population? Does this assessment correlate with actual extubation success? What factors (reasons, clinical status, ventilatory parameters) are associated with extubation readiness? Patients born before 28 weeks gestational age and admitted to the neonatal intensive care unit (NICU) within the first 24 hours are be included. The attending physician will complete a prospectively administered questionnaire with open-ended and multiple-choice questions to daily assess the decision and rationale for extubation or non-extubation of patients mechanically ventilated during the first 15 days of life.

Patient characteristics, respiratory outcomes, and mortality will be recorded until the end of hospitalisation and/or definitive weaning from any ventilatory support or supplemental oxygen.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

With prolonged stays in the neonatal intensive care unit (NICU) and significant respiratory morbidity, respiratory management of the most premature newborns - born before 28 weeks gestational age (GA) - brings a number of challenges. Despite recommendations to give priority to non-invasive ventilation in cases of respiratory insufficiency, recent studies show that over 80% of these newborns receive mechanical ventilation (MV) at least once in their NICU course, most within the first week of life (100% if born at 23 SA, \>90% at 24 and 25 SA, \>80% at 26 and \>70% at 27 weeks GA). Several studies have shown that a longer cumulative duration of MV is associated with a worse respiratory and neurodevelopmental prognosis in this population.

Early extubation is therefore recommended. However, extubation failures in patients born at these early stages of life are common and are per se associated with respiratory morbidity. Extubation failure is defined in the literature as reintubation within days of extubation.

A delay of 7 days after extubation has been identified as the time frame for capturing extubations related to respiratory causes. In a French study, using the SEPREVEN cohort for patients born before 27 weeks' GA, extubation failure at 3, 7 and 15 days concerned 25%, 33% and 50% of patients respectively. The decision to extubate a premature patient is a complex one, but contributes in part to the patient's outcome.

Shalish referred to the concept of "extubation readiness dilemma" to indicate the uncertainty surrounding the clinical features associated with successful extubation. Identifying a state for each patient that allows successful extubation, without reintubation in the following days, is most often based on ward routines in which assessments of the infant's respiratory capacity are taken into account. Medical literature doesn't provide recommendations on extubation criteria, and practices differ from one unit to another.

The aim of this study is to provide a detailed description of extubation practices and failures in several NICUs in France, based on a prospective collection of qualitative and mixed data.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

PreTerm Neonate Extubation Readiness Extubation Failure Respiratory Morbidity Bronchopulmonary Dysplasia Mechanical Ventilation

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Extremely Low Gestational Age Newborns (elgans)

No intervention. unique group.

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Gestational age \< 28 weeks of gestation
* Age at admission to the participating unit \<24 hours

Exclusion Criteria

* Parental opposition to their infant's clinical data collection
* Participation in a research protocol with potential impact on extubation and/or duration of mechanical ventilation
Minimum Eligible Age

1 Minute

Maximum Eligible Age

5 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Centre Hospitalier Intercommunal Creteil

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Dr Jean-michel Roue

Brest, Brest, France

Site Status COMPLETED

CHU Amiens Sud

Amiens, , France

Site Status COMPLETED

CH Cote Basque

Bayonne, , France

Site Status COMPLETED

CHU De Besancon

Besançon, , France

Site Status COMPLETED

Hopital Femme Mére Enfant - HFME

Bron, , France

Site Status COMPLETED

Centre Hospitalier Public du Cotentin

Cherbourg-Octeville, , France

Site Status COMPLETED

CH Estaing

Clermont-Ferrand, , France

Site Status COMPLETED

Chu Louis Mourier

Colombes, , France

Site Status COMPLETED

CHIC

Créteil, , France

Site Status COMPLETED

CHU Grenoble Alpes _site nord

Grenoble, , France

Site Status COMPLETED

CHU Félix Guyon

La Réunion, , France

Site Status COMPLETED

CHU Kremlin-Bicêtre

Le Kremlin-Bicêtre, , France

Site Status COMPLETED

CH Le Mans

Le Mans, , France

Site Status COMPLETED

CHU Lille

Lille, , France

Site Status COMPLETED

HME Limoges

Limoges, , France

Site Status COMPLETED

APHM_ Hôpital Nord

Marseille, , France

Site Status COMPLETED

GHEF- Site de MEAUX

Meaux, , France

Site Status COMPLETED

Chi Andre Gregoire

Montreuil, , France

Site Status RECRUITING

GHRMSA-Hopital Emile Muller

Mulhouse, , France

Site Status COMPLETED

CHU NICE

Nice, , France

Site Status COMPLETED

Chu Nimes

Nîmes, , France

Site Status COMPLETED

CH Orléans

Orléans, , France

Site Status COMPLETED

CHU Robert Debre

Paris, , France

Site Status COMPLETED

Chu Port Royal

Paris, , France

Site Status RECRUITING

CHU Necker

Paris, , France

Site Status COMPLETED

CHI Poissy - St Germain en LayE

Poissy, , France

Site Status COMPLETED

CHU Reims

Reims, , France

Site Status COMPLETED

CHU Rennes

Rennes, , France

Site Status COMPLETED

CH General Delafontaine

Saint-Denis, , France

Site Status COMPLETED

CH GHPSO

Senlis, , France

Site Status COMPLETED

CH Troyes

Troyes, , France

Site Status COMPLETED

Countries

Review the countries where the study has at least one active or historical site.

France

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Laurence Caeymaex, M.D, Ph.D

Role: CONTACT

0033664095607

Camille JUNG, MD PhD

Role: CONTACT

0033157022268

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Richard Wolff, Dr

Role: primary

Juliana PATKAI, Dr

Role: primary

References

Explore related publications, articles, or registry entries linked to this study.

Shalish W, Keszler M, Davis PG, Sant'Anna GM. Decision to extubate extremely preterm infants: art, science or gamble? Arch Dis Child Fetal Neonatal Ed. 2022 Jan;107(1):105-112. doi: 10.1136/archdischild-2020-321282. Epub 2021 Feb 24.

Reference Type BACKGROUND
PMID: 33627331 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

CERAINE

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.