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Positive End Expiratory Pressure With A T-piece Resuscitator For Near-Term and Term Infants With Respiratory Distress

Primary Purpose

Transient Tachypnea of the Newborn

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Neopuff
Sponsored by
Ain Shams University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Transient Tachypnea of the Newborn

Eligibility Criteria

undefined - 2 Days (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Near term infants (36-37 weeks gestational age) and Full term infants (38-41 weeks gestational age).
  • Presence of signs of respiratory distress (Tachypnea, intercostal and subcostal retractions, nasal flaring and grunting) evident shortly after birth.
  • Cesarean section (CS) was defined as elective when surgery was performed before the onset of labor, with all other cases defined as secondary CS.

Exclusion Criteria:

  • Presence of any of the risk factors for neonatal sepsis such as Prolonged Rupture of Membranes for ≥48 hours (PROM), maternal fever, maternal chorioamnionitis or positive maternal GBS colonization.
  • Presence of any other cause of respiratory distress, eg.

    • congenital malformations affecting the cardiorespiratory system ,
    • chromosomal aberrations,
    • depression at birth (Apgar score at 5 minutes of < 7 or umbilical artery pH of < 7.10),
    • fetal hydrops,
    • persistent pulmonary hypertension,
    • and meconium aspiration syndrome.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    No Intervention

    Arm Label

    Neopuff group

    Control group

    Arm Description

    includes 34 newborns showing signs of TTN who received CPAP (5 cm of H2O) via T- piece (Neopuff; Fisher and Paykel Healthcare, Auckland, New Zealand).

    includes 30 newborns who will receive nasal prong oxygen treatment; standard care according to Siva Subramanian et al. (2010).

    Outcomes

    Primary Outcome Measures

    Need for admissions to NICU secondary to TTN

    Secondary Outcome Measures

    Levels of plasma brain natriuretic peptide and clinical outcome [Time Frame: 24 hours].
    Duration of tachypnea.
    Duration and type of oxygen therapy.
    Antibiotic treatment.
    Incidence of pulmonary air leaks
    Length of hospital (NICU) stay
    Death

    Full Information

    First Posted
    May 16, 2013
    Last Updated
    May 20, 2013
    Sponsor
    Ain Shams University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01859533
    Brief Title
    Positive End Expiratory Pressure With A T-piece Resuscitator For Near-Term and Term Infants With Respiratory Distress
    Official Title
    Positive End Expiratory Pressure With A T-piece Resuscitator (Neopuff) For Near-Term and Term Infants With Respiratory Distress: A Randomized, Controlled Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2013
    Overall Recruitment Status
    Completed
    Study Start Date
    November 2011 (undefined)
    Primary Completion Date
    January 2013 (Actual)
    Study Completion Date
    May 2013 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Ain Shams University

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Evaluating the effect of early application of Continuous positive airway pressure (CPAP) via Neopuff in cases of transient tachypnea of the newborn(TTN) and its role in decreasing the duration and complication of TTN.
    Detailed Description
    The aim of the study is to determine whether positive end expiratory pressure therapy (PEEP) administered early via a T piece based infant resuscitator (Neopuff) would safely reduce the incidence of TTN and the need for neonatal intensive care unit (NICU) admission of near term and term infants with respiratory distress.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Transient Tachypnea of the Newborn

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    Outcomes Assessor
    Allocation
    Randomized
    Enrollment
    64 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Neopuff group
    Arm Type
    Experimental
    Arm Description
    includes 34 newborns showing signs of TTN who received CPAP (5 cm of H2O) via T- piece (Neopuff; Fisher and Paykel Healthcare, Auckland, New Zealand).
    Arm Title
    Control group
    Arm Type
    No Intervention
    Arm Description
    includes 30 newborns who will receive nasal prong oxygen treatment; standard care according to Siva Subramanian et al. (2010).
    Intervention Type
    Device
    Intervention Name(s)
    Neopuff
    Other Intervention Name(s)
    Early CPAP
    Intervention Description
    Group I neonates (Experimental group) includes 30 newborns showing signs of TTN who will receive administration of CPAP (5 cm of H2O) via T- piece (Neopuff; Fisher and Paykel Healthcare, Auckland, New Zealand). Group II neonates (Control group) includes 30 newborns who will receive nasal prong oxygen treatment; standard care according to Siva Subramanian et al. (2010).
    Primary Outcome Measure Information:
    Title
    Need for admissions to NICU secondary to TTN
    Time Frame
    24 hours
    Secondary Outcome Measure Information:
    Title
    Levels of plasma brain natriuretic peptide and clinical outcome [Time Frame: 24 hours].
    Time Frame
    24 hours
    Title
    Duration of tachypnea.
    Time Frame
    until discharge
    Title
    Duration and type of oxygen therapy.
    Time Frame
    ntil discharge
    Title
    Antibiotic treatment.
    Time Frame
    until discharge
    Title
    Incidence of pulmonary air leaks
    Time Frame
    ntil discharge
    Title
    Length of hospital (NICU) stay
    Time Frame
    until discharge
    Title
    Death
    Time Frame
    until discharge

    10. Eligibility

    Sex
    All
    Maximum Age & Unit of Time
    2 Days
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Near term infants (36-37 weeks gestational age) and Full term infants (38-41 weeks gestational age). Presence of signs of respiratory distress (Tachypnea, intercostal and subcostal retractions, nasal flaring and grunting) evident shortly after birth. Cesarean section (CS) was defined as elective when surgery was performed before the onset of labor, with all other cases defined as secondary CS. Exclusion Criteria: Presence of any of the risk factors for neonatal sepsis such as Prolonged Rupture of Membranes for ≥48 hours (PROM), maternal fever, maternal chorioamnionitis or positive maternal GBS colonization. Presence of any other cause of respiratory distress, eg. congenital malformations affecting the cardiorespiratory system , chromosomal aberrations, depression at birth (Apgar score at 5 minutes of < 7 or umbilical artery pH of < 7.10), fetal hydrops, persistent pulmonary hypertension, and meconium aspiration syndrome.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Rania A. El-Farrash, MD, PhD
    Organizational Affiliation
    Associate Professor of Pediatrics, Department of Pediatrics, Ain Shams University, Cairo, Egypt
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Amani O. Mahmoud, MD
    Organizational Affiliation
    Professor of Pediatrics, Department of Pediatrics, Ain Shams University, Cairo, Egypt
    Official's Role
    Study Chair
    First Name & Middle Initial & Last Name & Degree
    Enas H. Abdul-Hady, M.B.B.Ch
    Organizational Affiliation
    Ministry of Health
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Positive End Expiratory Pressure With A T-piece Resuscitator For Near-Term and Term Infants With Respiratory Distress

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