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Non-invasive high-frequency oscillatory ventilation versus nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome: Study protocol for a multi-center prospective randomized controlled trial.
- Source :
-
Trials [Trials] 2018 Jun 14; Vol. 19 (1), pp. 319. Date of Electronic Publication: 2018 Jun 14. - Publication Year :
- 2018
-
Abstract
- Background: Invasive mechanical ventilation (IMV) is associated with the development of adverse pulmonary and non-pulmonary outcomes in very premature infants. Various modes of non-invasive respiratory support are increasingly being used to decrease the incidence of bronchopulmonary dysplasia. The aim of this trial is to compare the effect of non-invasive high-frequency oscillatory ventilation (NHFOV) and nasal continuous positive airway pressure (NCPAP) in preterm infants with respiratory distress syndrome (RDS) as a primary non-invasive ventilation support mode.<br />Methods/design: In this multi-center randomized controlled trial, 300 preterm infants born at a gestational age of 26 <superscript>6/7</superscript> to 33 <superscript>6/7</superscript> weeks with a diagnosis of RDS will be randomized to NHFOV or NCPAP as a primary mode of non-invasive respiratory support. The study will be conducted in 18 tertiary neonatal intensive care units in China. The primary outcome is the need for IMV during the first 7 days after enrollment in preterm infants randomized to the two groups. The prespecified secondary outcomes include days of hospitalization, days on non-invasive respiratory support, days on IMV, days on supplemental oxygen, mortality, need for a surfactant, severe retinopathy of prematurity requiring laser treatment or surgery, patent ductus arteriosus needing ligation, bronchopulmonary dysplasia, abdominal distention, air leak syndromes, intraventricular hemorrhage (≥ grade 3), spontaneous intestinal perforation, necrotizing enterocolitis (≥II stage), and nasal trauma. Other secondary outcomes include Bayley Scales of Infant Development at 18-24 months of corrected age.<br />Discussion: In recent decades, several observational studies have compared the effects of NHFOV and NCPAP in neonates as a rescue mode or during weaning from IMV. To our knowledge, this will be the first multi-center prospective, randomized controlled trial to evaluate NHFOV as a primary mode in preterm infants with RDS in China or any other part of the world. Our trial may help to establish guidelines for NHFOV in preterm infants with RDS to minimize the need for IMV, and to decrease the significant pulmonary and non-pulmonary morbidities associated with IMV.<br />Trial Registration: ClinicalTrials.gov, NCT03099694 . Registered on 4 April 2017.
- Subjects :
- Age Factors
Child Development
China
Female
Gestational Age
Humans
Infant
Infant, Newborn
Male
Multicenter Studies as Topic
Noninvasive Ventilation adverse effects
Prospective Studies
Randomized Controlled Trials as Topic
Respiratory Distress Syndrome, Newborn diagnosis
Respiratory Distress Syndrome, Newborn physiopathology
Time Factors
Treatment Outcome
Continuous Positive Airway Pressure adverse effects
Infant, Premature
Noninvasive Ventilation methods
Premature Birth
Respiratory Distress Syndrome, Newborn therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1745-6215
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Trials
- Publication Type :
- Academic Journal
- Accession number :
- 29898763
- Full Text :
- https://doi.org/10.1186/s13063-018-2673-9