Restricted Versus Liberal Fluid Intake for Prevention of Bronchopulmonary Dysplasia

NCT ID: NCT06954142

Last Updated: 2025-08-19

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

Clinical Phase

NA

Total Enrollment

750 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-12

Study Completion Date

2029-12-31

Brief Summary

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

The aim of this study is to determine whether restricted fluid intake (135 ±5 mL/kg/day) compared to liberal fluid intake (165 ±5 mL/kg/day) from day 8 of life reduces the incidence of bronchopulmonary dysplasia (BPD) at 36 weeks postmenstrual age or prior death in preterm infants born \<30 weeks gestational age.

Detailed Description

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

Complications of preterm birth remain the leading cause of death in children under five years of age worldwide, accounting for approximately one million deaths annually. Among the survivors, bronchopulmonary dysplasia (BPD) is the most common severe complication. BPD is a chronic lung disease characterized by prolonged need for respiratory support and oxygen therapy, poor postnatal growth, and long-term impairments in lung function and neurodevelopment.

Despite advancements in neonatal care, BPD is the most common chronic lung disease in infancy and associated with increased mortality, repeated hospitalisation throughout childhood, impaired lung function up into adulthood, and long-term neurodevelopmental impairment. The incidence of BPD has remained stable over the past 15 years. This is likely due to the improved survival of extremely preterm infants, who are at the highest risk for BPD.

A key feature of evolving BPD is the accumulation of interstitial pulmonary edema, which reduces lung compliance and increases the need for respiratory support, thereby perpetuating a cycle of lung damage.

Currently, diuretics are sometimes used to manage pulmonary edema in preterm infants. While they can improve lung function in the short term, they come with potential risks including bone demineralization, nephrotoxicity, electrolyte imbalances, and impaired growth.

As a potentially safer alternative, fluid restriction is sometimes used to prevent or manage pulmonary edema. It is hypothesized to improve lung mechanics and reduce the need for respiratory support, without the adverse effects associated with medications. However, there is no robust evidence on optimal fluid targets in these patients.

SwissNeoNet, consisting of all nine Swiss NICUs, is a mandatory national registry, where data on all infants born before 32 weeks of gestation and/or with a birth weight \< 1501 g are collected. Fluid management practices vary among Swiss neonatal intensive care units (NICUs) following international guidelines recommending 135 to 180 mL/kg/day of fluids. This variation may contribute to the differing rates of BPD and mortality observed across centers, but fluid intake is not routinely captured in SwissNeoNet data, making it difficult to assess its impact.

In summary, although fluid restriction shows potential as a simple and low-risk intervention to reduce the incidence of BPD, current evidence is insufficient to support its routine use. There is a clear need for a robust, contemporary, and pragmatic trial to evaluate whether fluid restriction, started after the first week of life, can safely and effectively reduce the incidence of BPD or death in very preterm infants.

Conditions

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

Bronchopulmonary Dysplasia

Study Design

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

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Pragmatic, registry-linked, multicentre, open-label, cluster-randomised, multiple period, cross-over, effectiveness trial
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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

Fluid restriction

Fluid restriction strategy (fluid target 135 ±5 mL/kg/d). This is standard of care.

Group Type EXPERIMENTAL

Fluid restriction

Intervention Type OTHER

Fluid restriction strategy (fluid target 135 ±5 mL/kg/d)

Liberal fluid intake

Liberal fluid intake strategy (fluid target 165 ± 5 mL/kg/d) in line with international best practice recommendations on nutrition.

Group Type ACTIVE_COMPARATOR

Liberal fluid intake

Intervention Type OTHER

Liberal fluid intake strategy (fluid target 165 ± 5 mL/kg/d)

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Fluid restriction

Fluid restriction strategy (fluid target 135 ±5 mL/kg/d)

Intervention Type OTHER

Liberal fluid intake

Liberal fluid intake strategy (fluid target 165 ± 5 mL/kg/d)

Intervention Type OTHER

Eligibility Criteria

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

Inclusion Criteria

* Hospitalised preterm infants born before 30 weeks 0 days gestation
* Signed informed consent for further research use of health-related data

Exclusion Criteria

* congenital malformations
* diseases likely to affect life expectancy, lung function, fluid strategy, or neurodevelopment
* renal disease requiring fluid management outside the clinical standard of care
* congenital heart disease not including patent ductus arteriosus (PDA)
Minimum Eligible Age

8 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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

Swiss Neonatal Network

NETWORK

Sponsor Role collaborator

University Children's Hospital Basel

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

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Sven Schulzke, Prof.MD

Role: PRINCIPAL_INVESTIGATOR

University Children's Hospital Basel, UKBB

Locations

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

Kantonsspital Aarau AG, Klinik für Kinder u. Jugendliche

Aarau, , Switzerland

Site Status RECRUITING

University Children's Hospital Basel (UKBB)

Basel, , Switzerland

Site Status RECRUITING

Inselspital Bern, Kinderklinik

Bern, , Switzerland

Site Status RECRUITING

Kantonsspital Graubünden, Departement Kinder- und Jugendmedizin

Chur, , Switzerland

Site Status RECRUITING

Hôpitaux universitaires de Genève (HUG), Unité de Néonatologie

Geneva, , Switzerland

Site Status RECRUITING

Centre hospitalier universitaire vaudois (CHUV) - Service de néonatologie

Lausanne, , Switzerland

Site Status RECRUITING

Luzerner Kantonsspital, Kinderspital

Lucerne, , Switzerland

Site Status RECRUITING

Ostschweizer Kinderspital & Neonatologie und Frauenklinik KSSG, Perinatalzentrum St. Gallen

Sankt Gallen, , Switzerland

Site Status RECRUITING

UniversitätsSpital Zürich, Klinik für Neonatologie

Zurich, , Switzerland

Site Status RECRUITING

Countries

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

Switzerland

Central Contacts

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

Anne Carrer

Role: CONTACT

+4161 704 2853

Michel Schrutt

Role: CONTACT

Facility Contacts

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

Philipp Meyer, KD Dr. med.

Role: primary

+41 62 838 49 48

Sven Schulzke, Prof. MD

Role: primary

+41 61 5565486

Benjamin Stöcklin, PD MD

Role: backup

André Kidszun, Prof. MD

Role: primary

+41 31 632 21 11

Marta Busso, MD

Role: backup

+41 76 2324427

Bjarte Rogdo, Dr. med.

Role: primary

+41 81 256 6400

Francisca Barcos Munoz, MD

Role: primary

+41 22 372 68 16

Riccardo Pfister, Prof. MD

Role: backup

Eric Giannoni, Assoc. Prof.

Role: primary

+41 21 314 34 60

Sébastien Joye, MD

Role: backup

+41 21 314 3464

Martin Stocker, Prof. MD

Role: primary

+41 (0)41 205 32 31

André Birkenmaier, Dr.med.

Role: primary

+41 (0)71 243 71 11

David Glauser, MD

Role: primary

+41 43 253 87 59

Dirk Bassler, Prof. MD

Role: backup

+41 44 255 11 11

Other Identifiers

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

2025-00321; ks22Schulzke

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

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

Hydrocortisone for BPD
NCT01353313 COMPLETED PHASE3
Duodenal Feeds in Very Low Birth Weight Infants
NCT04246333 ACTIVE_NOT_RECRUITING NA