Early Surfactant Administration at FiO₂ >0.25 Under NIPPV for RDS in Very Preterm Infants

NCT ID: NCT07100652

Last Updated: 2025-08-03

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

384 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-01

Study Completion Date

2027-02-01

Brief Summary

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This multicenter randomized controlled trial investigates whether initiating pulmonary surfactant (PS) at a lower oxygen threshold (FiO₂ \>0.25) during nasal intermittent positive pressure ventilation (NIPPV) for very preterm infants with respiratory distress syndrome (RDS) reduces noninvasive ventilation failure rates (primary outcome: intubation requirement), compared to the standard threshold (FiO₂ \>0.3). By establishing the clinical superiority of early PS administration, this study aims to refine evidence-based guidelines for RDS management in preterm neonates.

Detailed Description

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Conditions

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Respiratory Distress Syndrome (&Amp; [Hyaline Membrane Disease])

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Lower oxygen threshold group (FiO₂ >0.25)

Surfactant was administered as a single initial dose when the fraction of inspired oxygen (FiO₂) exceeded 0.25

Group Type EXPERIMENTAL

Threshold FiO₂

Intervention Type PROCEDURE

Group 1 (Intervention Group) received the initial dose of pulmonary surfactant immediately upon reaching an inhaled oxygen concentration (FiO₂) \>0.25.

Group 2 (Control Group) received the initial dose of pulmonary surfactant as early as possible within 48 hours, but only when FiO₂ was titrated to \>0.3 based on the infant's clinical condition.

Higer oxygen threshold group (FiO₂ >0.3)

Surfactant was administered as a single initial dose when the fraction of inspired oxygen (FiO₂) exceeded 0.3

Group Type ACTIVE_COMPARATOR

Threshold FiO₂

Intervention Type PROCEDURE

Group 1 (Intervention Group) received the initial dose of pulmonary surfactant immediately upon reaching an inhaled oxygen concentration (FiO₂) \>0.25.

Group 2 (Control Group) received the initial dose of pulmonary surfactant as early as possible within 48 hours, but only when FiO₂ was titrated to \>0.3 based on the infant's clinical condition.

Interventions

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Threshold FiO₂

Group 1 (Intervention Group) received the initial dose of pulmonary surfactant immediately upon reaching an inhaled oxygen concentration (FiO₂) \>0.25.

Group 2 (Control Group) received the initial dose of pulmonary surfactant as early as possible within 48 hours, but only when FiO₂ was titrated to \>0.3 based on the infant's clinical condition.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* (1) Gestational Age: 26 weeks +0 day to 31 weeks+6days at birth (inclusive). (2) Clinical Diagnosis of NRDS: Symptoms: Tachypnea, grunting, and/or progressive respiratory distress. Imaging Findings: Chest X-ray showing at least one of: Ground-glass opacity, Air bronchograms, Diffuse "white lung" pattern, Lung Ultrasound (recommended).

(3) Admission to NICU within 3 hours of birth. Requirement for non-invasive nasal intermittent positive pressure ventilation (NIPPV) at enrollment.

(4) Signed informed consent obtained from parent(s) or legal guardian(s).

Exclusion Criteria

1. Invasive mechanical ventilation during delivery or transport to NICU.
2. Structural upper airway abnormalities precluding non-invasive ventilation.
3. Confirmed diagnosis of major congenital malformations
4. Endotracheal intubation for indications unrelated to NRDS (e.g., surgery, sepsis management)
5. Initiation of non-invasive ventilation \>3 hours post-birth.
6. Voluntary discharge or treatment withdrawal within 72 hours post-enrollment.
7. Parental/guardian refusal to Sign informed consent or Authorize surfactant administration
8. Incomplete clinical records or missing key outcome variables

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Maximum Eligible Age

3 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jiangxi Maternal and Child Health Hospital

OTHER

Sponsor Role collaborator

Jiulongpo No.1 People's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xingwang Zhu

Jiangxi Maternal and Child Health Hospital, Jiangxi, 337000, China

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Jiangxi Maternal and Child Health Hospital

Nanchang, Jiangxi, China

Site Status

Countries

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China

Central Contacts

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Yuan Shi, PhD

Role: CONTACT

0791-86224432

Facility Contacts

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Xingwang Zhu

Role: primary

+86 150843335697

Other Identifiers

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Jiangxi Maternal and Child

Identifier Type: -

Identifier Source: org_study_id

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