Comparison of Continuous Positive Airway Pressure (CPAP) and Non-Invasive Positive Pressure Ventilation (NIPPV) in Preterm Newborns With Respiratory Distress Syndrome.

NCT ID: NCT06966752

Last Updated: 2025-05-13

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

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-25

Study Completion Date

2027-05-01

Brief Summary

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Primary objective: to evaluate safety and efficacy of two different non-invasive respiratory support modalities in preterm neonatal patients with respiratory distress syndrome.

Secondary objective is to compare different respiratory support mode performance in different gestational age groups.

Primary endpoint is treatment failure.

With this study, the following hypotheses will be tested:

Hypothesis 1: NIPPV has a lower failure rate compared to CPAP mode. Hypothesis 2: NIPPV complication rate is non-superior compared to CPAP.

Detailed Description

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Treatment failure is defined as any of the following:

* FiO2\>0.6 to maintain SpO2\>88%
* Respiratory acidosis (pH\<7.2, pCO2\>65 mmHg)
* recurrent apnea (\>4 episodes/h) or apnea requiring bag and mask ventilation
* Silverman Andersen respiratory severity score (SAS score) ≥6 and does not improve by \> 20% within 4-8 hours

Secondary endpoints:

* Mortality rate
* Intubation rate
* Late onset sepsis (LOS) rate
* Treatment duration
* Complication rates:

Pneumothorax rate Bronchopulmonary dysplasia (BPD) Necrotizing enterocolitis (NEC) Persisting ductus arteriosus (PDA) Intraventricular hemorrhage (IVH) Retinopathy of prematurity (ROP)

Nasal trauma:

* I° - nasal/septal redness
* II° - nasal/septal redness + indent
* III° - nasal/septal redness + indent + skin breakdown

Abdominal distension:

* Visible abdominal distension (defined by attending clinician) AND one of the following:
* Feeding intolerance (defined by clinician) OR
* \>3 desaturation episodes or \>20% FiO2 increase in 1 hour after feed.

With this study, the following hypotheses will be tested:

Hypothesis 1: NIPPV has a lower failure rate compared to CPAP mode. Hypothesis 2: NIPPV complication rate is non-superior compared to CPAP.

Conditions

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Respiratory Distress Syndrome (RDS)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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CPAP

Patients under CPAP respiratory support.

Group Type ACTIVE_COMPARATOR

NIPPV

Intervention Type OTHER

NIPPV

* PEEP 6-8 cmH2O
* PIP: 14-16 cmH2O
* Tinsp: 0.3-0.5sec

* \<28 weeks GA: 0.3 - 0.4 sec
* \>28weeks GA: 0.4 - 0.5 sec
* Rate: 20-35 breaths per minute.

NIPPV

Patients under Noninvasive positive pressure ventilation (NIPPV).

Group Type EXPERIMENTAL

CPAP

Intervention Type OTHER

CPAP pressure of 6-8 mmH2O

Interventions

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NIPPV

NIPPV

* PEEP 6-8 cmH2O
* PIP: 14-16 cmH2O
* Tinsp: 0.3-0.5sec

* \<28 weeks GA: 0.3 - 0.4 sec
* \>28weeks GA: 0.4 - 0.5 sec
* Rate: 20-35 breaths per minute.

Intervention Type OTHER

CPAP

CPAP pressure of 6-8 mmH2O

Intervention Type OTHER

Other Intervention Names

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Noninvasive positive pressure ventilation Nasal Continuous Airway Pressure nCPAP

Eligibility Criteria

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Inclusion Criteria

1. gestational age (GA) between 22+0 and 34+6 weeks (estimated on the postmenstrual date and early gestation ultrasonographic findings).
2. Need of respiratory support (deemed by a clinician).

Exclusion Criteria

1. Major congenital anomalies
2. Cardiovascular instability
3. Consent refused or not provided
Minimum Eligible Age

0 Minutes

Maximum Eligible Age

44 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vilnius University

OTHER

Sponsor Role lead

Responsible Party

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Arunas Liubsys

Associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Vilnius University Santaros Klinikos

Vilnius, Vilnius County, Lithuania

Site Status RECRUITING

Countries

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Lithuania

Central Contacts

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Arunas Liubsys, Associate Professor

Role: CONTACT

+370 6 872 2520

Ernestas Virsilas

Role: CONTACT

+37060787438

Facility Contacts

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Arunas Liubsys

Role: primary

+37068722520

Ernestas Virsilas

Role: backup

+37060787438

Other Identifiers

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NC3

Identifier Type: -

Identifier Source: org_study_id

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