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Набор скоро начнётся NCT07100652

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

Без фазы С лечением Respiratory Distress Syndrome (&Amp; [Hyaline Membrane Disease])

Ориентир для пациента и семьи

Простыми словами

Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.

Что изучают
В протоколе указаны: Threshold FiO₂.
Кому может быть актуально
Состояния в реестре: Respiratory Distress Syndrome (&Amp; [Hyaline Membrane Disease]). Базовые параметры: до 3 Hours · Все.
Что важно проверить
Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
Где проводится
Китай
Следующий шаг
Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
Официальное название

Comparing Different Oxygen Thresholds for Surfactant Administration During Nasal IPPV in Very Preterm Neonates With Respiratory Distress Syndrome: A Superiority RCT

Обзор

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.

Вмешательства

  • Процедура 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.

Первичные конечные точки

  • Non-invasive respiratory support failure, defined by the need for IMV within 72 after birth [Срок оценки: 72 hours after birth]
Вторичные конечные точки (12)
  • The requirement for repeated pulmonary surfactant administration, including the total number of doses utilized [Срок оценки: 7 days after birth]
  • BPD, defined according to the NICHD definition [Срок оценки: 3 months after birth]
  • airleaks occurred after the extubation [Срок оценки: 3 months after birth]
  • retinopathy of prematurity (ROP) > 2nd stage [Срок оценки: 3 months after birth]
  • necrotizing enterocolitis (NEC) ≥ 2nd stage [Срок оценки: 3 months after birth]
  • IVH > 2nd grade [Срок оценки: 3 mionths after birth]
  • hemodynamically significant patent ductus arteriosus (PDA) [Срок оценки: 3 months after birth]
  • weekly weight gain (in grams/d) for the first 4 weeks of life or until NICU discharge, whichever comes first. [Срок оценки: 3 months after birth]
  • Duration of non-invasive respiratory support [Срок оценки: 3 months after birth]
  • total hospitalization cost [Срок оценки: 6 months after birth]
  • nasal skin injury [Срок оценки: 3 months after birth]
  • in-hospital mortality [Срок оценки: 6 months after birth]

Критерии участия

Критерии включения

  • (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).

Критерии исключения

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

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Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение
Рандомизированное
Модель
Параллельные группы
Маскирование
Простое слепое
Основная цель
Лечение

Центры проведения

Китай · 1 центр
  • Jiangxi Maternal and Child Health Hospital — Nanchang

Публикации

  • Yang R, Fang Z, Liu KZ, Zhu X, Ding XP, Luo Q, Zhou WJ, Hu XW, Zhou JL, Tang WY, Shi Y. Comparison of two fractions of inspired oxygen thresholds (0.25 vs 0.30) for surfactant administration in very preterm infants with respiratory distress syndrome under nasal intermittent positive pressure ventilation: study protocol for a multicentre randomised controlled, superiority trial. BMJ Paediatr Open. PMID 41213831

Идентификаторы

NCT: NCT07100652 · Jiangxi Maternal and Child

Первоисточники (государственные реестры)

Открыть это исследование на ClinicalTrials.gov ↗