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The purpose of this study is to establish if a strategy of EBCPAP application in a subgroup of VLBWI, 800 to 1500g birthweight, decreases the need for mechanical ventilation in this group, without affecting mortality.
The application of CPAP has been described as an alternative respiratory support for premature newborns with respiratory distress.Many studies support that the early use of CPAP results in a better respiratory evolution and less need for mechanical ventilation.
Hypothesis:
- The hypothesis is that EBCPAP will decrease the need for this more invasive therapy.
The primary endpoint in this multicenter controlled study is to establish if an strategy of EBCPAP application in a subgroup of VLBWI, 800 to 1500g birthweight, decreases the need for mechanical ventilation in this group, without affecting mortality. .
As secondary outcome, the investigators will analyse: days of oxygen therapy, days of mechanical ventilation, need for surfactant , pulmonary airleak, intraventricular hemorrhage, persistent ductus arteriosus, retinopathy of prematurity and bronchopulmonary dysplasia (BPD) at 28 days and 36 weeks corrected gestational age.
Comparison(s):
Early Bubble CPAP (EBCPAP)with Standard Therapy which is oxygen.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Early Bubble CPAP | Device |
| Measure | Description | Time Frame |
|---|---|---|
| Need for mechanical ventilation |
| Measure | Description | Time Frame |
|---|---|---|
| Days of oxygen therapy | ||
| Days of mechanical ventilation | ||
| Need for surfactant |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| José Luis Tapia, MD | Contact | 56-2-3546437 | jlta@med.puc.cl | |
| Soledad Urzua, MD | Contact | 56-2-3543348 | soleurzua@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| José Luis Tapia, MD | Pontificia Universidad Católica | Principal Investigator |
| Aldo Bancalari, MD | Hospital Guillermo Grant | Principal Investigator |
| Soledad Urzua, MD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Servicio de Neonatología, Hospital de Clínicas José de San Martín | Recruiting | Buenos Aires | Argentina |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 4930602 | Background | Gregory GA, Kitterman JA, Phibbs RH, Tooley WH, Hamilton WK. Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure. N Engl J Med. 1971 Jun 17;284(24):1333-40. doi: 10.1056/NEJM197106172842401. No abstract available. | |
| 1097619 | Background | Krouskop RW, Brown EG, Sweet AY. The early use of continuous positive airway pressure in the treatment of idiopathic respiratory distress syndrome. J Pediatr. 1975 Aug;87(2):263-7. doi: 10.1016/s0022-3476(75)80599-3. |
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
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| Pulmonary airleak |
| Intraventricular hemorrhage |
| Persistent ductus arteriosus |
| retinopathy of prematurity |
| Bronchopulmonary dysplasia (BPD) at 28 days and 36 weeks corrected gestational age. |
| Pontificia Universidad Católica |
| Principal Investigator |
| Servicio de Neonatología, Hospital Fernández | Recruiting | Buenos Aires | Argentina |
|
| Servicio de Neonatología, Hospital Italiano | Recruiting | Buenos Aires | Argentina |
|
| Servicio de Neonatología, Maternidad Sardá | Recruiting | Buenos Aires | Argentina |
|
| Servicio de Neonatología, Hospital Lagomaggiore | Recruiting | Mendoza | Argentina |
|
| Servicio de Neonatología, Hospital Guillermo Grant | Recruiting | Concepción | Biobio | Chile |
|
| Servicio de Neonatología, Hospital Clínico Universidad de Chile | Recruiting | Santiago | Santiago Metropolitan | Chile |
|
| Servicio de Neonatología, Hospital San José | Not yet recruiting | Santiago | Santiago Metropolitan | Chile |
|
| Servicio de Neonatología, Hospital Sótero del Rio | Not yet recruiting | Santiago | Santiago Metropolitan | Chile |
|
| Unidad de Neonatología, Hospital Clínico Pontificia Universidad Católica | Recruiting | Santiago | Santiago Metropolitan | Chile |
|
| Servicio de Neonatología, Hospital Gustavo Fricke | Suspended | Viña del Mar | Valparaiso | Chile |
| Servicio de Neonatología, Hospital de Clinicas Universidad Nacional Asunción | Not yet recruiting | Asunción | Paraguay |
|
| Servicio de Neonatología, Hospital Cayetano Heredia | Recruiting | Lima | Peru |
|
| Servicio de neonatología, Centro Hospitalario Pereira Rosseli | Not yet recruiting | Montevideo | Uruguay |
|
| 326199 | Background | Allen LP, Reynolds ER, Rivers RP, Le Souef PM, Wimberley PD. Controlled trial of continuous positive airway pressure given by face mask for hyaline membrane disease. Arch Dis Child. 1977 May;52(5):373-8. doi: 10.1136/adc.52.5.373. |
| 6780266 | Background | Hegyi T, Hiatt IM. The effect of continuous positive airway pressure on the course of respiratory distress syndrome: the benefits on early initiation. Crit Care Med. 1981 Jan;9(1):38-41. doi: 10.1097/00003246-198101000-00009. |
| 8477167 | Background | Kamper J, Wulff K, Larsen C, Lindequist S. Early treatment with nasal continuous positive airway pressure in very low-birth-weight infants. Acta Paediatr. 1993 Feb;82(2):193-7. doi: 10.1111/j.1651-2227.1993.tb12637.x. |
| 10393390 | Background | Kamper J. Early nasal continuous positive airway pressure and minimal handling in the treatment of very-low-birth-weight infants. Biol Neonate. 1999 Jun;76 Suppl 1:22-8. doi: 10.1159/000047043. |
| 8839743 | Background | Lundstrom KE. Initial treatment of preterm infants--continuous positive airway pressure or ventilation? Eur J Pediatr. 1996 Aug;155 Suppl 2:S25-9. doi: 10.1007/BF01958077. |
| 10835057 | Background | Van Marter LJ, Allred EN, Pagano M, Sanocka U, Parad R, Moore M, Susser M, Paneth N, Leviton A. Do clinical markers of barotrauma and oxygen toxicity explain interhospital variation in rates of chronic lung disease? The Neonatology Committee for the Developmental Network. Pediatrics. 2000 Jun;105(6):1194-201. doi: 10.1542/peds.105.6.1194. |
| 10430740 | Background | Michna J, Jobe AH, Ikegami M. Positive end-expiratory pressure preserves surfactant function in preterm lambs. Am J Respir Crit Care Med. 1999 Aug;160(2):634-9. doi: 10.1164/ajrccm.160.2.9902016. |
| 9925870 | Background | Verder H, Albertsen P, Ebbesen F, Greisen G, Robertson B, Bertelsen A, Agertoft L, Djernes B, Nathan E, Reinholdt J. Nasal continuous positive airway pressure and early surfactant therapy for respiratory distress syndrome in newborns of less than 30 weeks' gestation. Pediatrics. 1999 Feb;103(2):E24. doi: 10.1542/peds.103.2.e24. |
| 12076463 | Background | Ho JJ, Henderson-Smart DJ, Davis PG. Early versus delayed initiation of continuous distending pressure for respiratory distress syndrome in preterm infants. Cochrane Database Syst Rev. 2002;2002(2):CD002975. doi: 10.1002/14651858.CD002975. |
| 16034858 | Background | Subramaniam P, Henderson-Smart DJ, Davis PG. Prophylactic nasal continuous positive airways pressure for preventing morbidity and mortality in very preterm infants. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD001243. doi: 10.1002/14651858.CD001243.pub2. |
| 9483299 | Background | Lee KS, Dunn MS, Fenwick M, Shennan AT. A comparison of underwater bubble continuous positive airway pressure with ventilator-derived continuous positive airway pressure in premature neonates ready for extubation. Biol Neonate. 1998;73(2):69-75. doi: 10.1159/000013962. |
| 11328472 | Background | De Klerk AM, De Klerk RK. Nasal continuous positive airway pressure and outcomes of preterm infants. J Paediatr Child Health. 2001 Apr;37(2):161-7. doi: 10.1046/j.1440-1754.2001.00624.x. |
| 12732855 | Background | Narendran V, Donovan EF, Hoath SB, Akinbi HT, Steichen JJ, Jobe AH. Early bubble CPAP and outcomes in ELBW preterm infants. J Perinatol. 2003 Apr-May;23(3):195-9. doi: 10.1038/sj.jp.7210904. |
| 22402568 | Derived | Tapia JL, Urzua S, Bancalari A, Meritano J, Torres G, Fabres J, Toro CA, Rivera F, Cespedes E, Burgos JF, Mariani G, Roldan L, Silvera F, Gonzalez A, Dominguez A; South American Neocosur Network. Randomized trial of early bubble continuous positive airway pressure for very low birth weight infants. J Pediatr. 2012 Jul;161(1):75-80.e1. doi: 10.1016/j.jpeds.2011.12.054. Epub 2012 Mar 6. |