Predictors for Nasal Intermittent Positive Pressure Ventilation Failure for Premature Infants With Respiratory Distress Syndrome
Study Details
Study Description
Brief Summary
Non-invasive respiratory support methods have been widely used in premature babies with respiratory distress syndrome (RDS) which has changed the basic management of premature babies in the early period. According to the 2019 European Guidelines on RDS management, early nasal CPAP is recommended as first-line therapy in infants <30 weeks of age who are at risk of RDS who do not require mechanical ventilation (MV). However, some of the premature babies have faced non-invasive ventilation failure. Remarkably, infants who experience non-invasive ventilation failure are at increased risk of death, pneumothorax, intraventricular hemorrhage, and bronchopulmonary dysplasia (BPD), among other morbidities. In non-invasive ventilation failure, although demographic factors such as small gestational age, low birth weight, and male gender play a role, it has been suggested that surfactant deficiency may also play an important role. The most frequently reported risk factor in predicting non-invasive failure in studies is the fraction of inspiring oxygen during the first hours of life. In addition, positive end-expiratory airway pressure (PEEP) required for patient stabilization was found to be a potential predictor. However, there are still limited data to predict non-invasive ventilation failure. "Which newborns are at high risk for non-invasive ventilation failure?" and "When should the surfactant be applied?". The study is a single-center, prospective study to evaluate prognostic factors, and most importantly to define the FiO2 threshold, which is an indicator of possible non-invasive ventilation failure in infants supported with nasal intermittent positive pressure ventilation.
Condition or Disease | Intervention/Treatment | Phase |
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Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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non-invasive ventilation failure babies who will be intubated in the first 72 hours |
Other: non-invasive ventilation
Babies who will have or won't have non-invasive ventilation failure in the first 72 hoursof life, will be compared.
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non-invasive ventilation success babies who will not intubated in the first 72 hours |
Other: non-invasive ventilation
Babies who will have or won't have non-invasive ventilation failure in the first 72 hoursof life, will be compared.
|
Outcome Measures
Primary Outcome Measures
- Risk of intubation in the first 72 hours in premature babies [2 year]
To determine the risk of intubation in the first 72 hours of life in premature babies less than 32 weeks of gestation who have supported with nasal intermittent positive pressure ventilation
Secondary Outcome Measures
- To describe the incidence and early precursors of non-invasive ventilation failure. [2 year]
Invasive, non-invasive ventilation and supplemental oxygen day time
- Looking for early predictors, [2 year]
Looking for early predictors, including combinations of breathed oxygen fraction (FiO2) and non-invasive ventilation level in early life
- morbidity and mortality [2 year]
To investigate the negative consequences of non-invasive ventilation failure.
Eligibility Criteria
Criteria
Inclusion Criteria:
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<32 weeks preterm babies
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Those who have received nasal intermittent positive pressure ventilation
Exclusion Criteria:
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Babies born> 32 weeks
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Babies with congenital anomalies
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Babies who have intubated in the delivery room
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Babies whose parents refuse to participitate
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Ankara City Hospital Bilkent | Ankara | Turkey | 06000 |
Sponsors and Collaborators
- Ankara City Hospital Bilkent
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Dargaville PA, Aiyappan A, De Paoli AG, Dalton RG, Kuschel CA, Kamlin CO, Orsini F, Carlin JB, Davis PG. Continuous positive airway pressure failure in preterm infants: incidence, predictors and consequences. Neonatology. 2013;104(1):8-14. doi: 10.1159/000346460. Epub 2013 Apr 4.
- Gulczyńska E, Szczapa T, Hożejowski R, Borszewska-Kornacka MK, Rutkowska M. Fraction of Inspired Oxygen as a Predictor of CPAP Failure in Preterm Infants with Respiratory Distress Syndrome: A Prospective Multicenter Study. Neonatology. 2019;116(2):171-178. doi: 10.1159/000499674. Epub 2019 May 21.
- Shi Y, Tang S, Zhao J, Shen J. A prospective, randomized, controlled study of NIPPV versus nCPAP in preterm and term infants with respiratory distress syndrome. Pediatr Pulmonol. 2014 Jul;49(7):673-8. doi: 10.1002/ppul.22883. Epub 2013 Sep 4.
- E1-20-1250