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This work is designed to:
There is a preference of using noninvasive modes of ventilation for management of respiratory distress syndrome (RDS) in preterm infants and of weaning of ventilated neonates as soon as possible to non-invasive modes.
Yet, little is known about which non-invasive mode is better and the hemodynamic changes that occur to the infants secondary to these modes. The study provides an evaluation of the efficacy of heated, humidified high flow nasal cannula (HHHFNC) in comparison to nasal continuous positive airway pressure (nCPAP) in preterm infants. Secondary aim is to assess echographic, cerebral blood flow and mesenteric blood flow changes during HHHFNC versus nCPAP.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HHHFNC | it included 63 preterm neonates on Heated, Humidified High Flow Nasal Cannula, of which 35 preterm underwent functional echocardiography, transcranial ultrasonography Doppler applied to the anterior cerebral artery and assessment of pre-prandial superior mesenteric artery velocity and volume of blood flow with Doppler sonography. All of which done while on non invasive ventilation and after weaning. |
| |
| NCPAP | it included 60 preterm neonates on Nasal Continuous Positive Airway Pressure, of which 35 preterm underwent functional echocardiography, transcranial ultrasonography Doppler applied to the anterior cerebral artery and assessment of pre-prandial superior mesenteric artery velocity and volume of blood flow with Doppler sonography. All of which done while on non invasive ventilation and after weaning. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Functional Echocardiography | Diagnostic Test | Imaging studies to assess Hemodynamics of both groups on and off non invasive ventilation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Echocardiography study for preterm neonates among the two study groups while on and off non invasive ventilation. | Done using Bedside functional echocardiography to record Superior vena caval flow (ml/kg/min), right ventricular output flow (ml/kg/min) and left ventricular output flow (ml/kg/min) for each preterm neonate in one of the two study groups (using either HHHFNC and nCPAP) on and off respiratory support. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the efficacy of HHHFNC in comparison with nCPAP in preterm neonates. | The percentage of success and failure among the HHHFNC and nCPAP groups , success defined as the preterm neonate that will not require invasive ventilation, while failure as the preterm neonate that will require invasive ventilation. | 2 years |
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Inclusion Criteria:
Infants are eligible if they meet the following criteria:
Exclusion Criteria:
Preterm neonates with evidence of any of the following will be excluded:
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The study will be conducted on preterm neonates who required ventilatory support for respiratory distress syndrome (RDS) with previous invasive ventilation or not. The involved study group will be of matched gestational, postnatal age and sex.
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| Name | Affiliation | Role |
|---|---|---|
| Prof. Hisham Abdel Samie Awad | Ain Shams University,Medical school, Pediatrics department | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 38 abbasia, next to nour mosque, Ain Shams University Hospital, Pediatrics department | Cairo | 11517 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42243499 | Derived | El-Farrash RA, Shinkar DM, Awad HA, Soliman NM, Al Sharabasy AH, Farid YA. Hemodynamic changes in preterm neonates with respiratory distress syndrome: high-flow nasal cannula versus nasal continuous positive airway pressure-a randomized controlled trial. Pediatr Res. 2026 Jun 4. doi: 10.1038/s41390-026-05127-9. Online ahead of print. |
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| ID | Term |
|---|---|
| D012127 | Respiratory Distress Syndrome, Newborn |
| D012128 | Respiratory Distress Syndrome |
| D047928 | Premature Birth |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D007235 | Infant, Premature, Diseases |
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| Anterior cerebral artery Doppler (measuring resistive index) and preprandial Superior mesenteric artery Doppler (measuring resistive index). |
Anterior cerebral artery resistive index and preprandial Superior mesenteric artery resistive index measured for 70 preterm neonate on and off non invasive ventilation. 35 preterm placed on HHHFNC in comparison to 35 preterm placed on nCPAP. |
| 2 years |
| Preprandial Superior mesenteric artery Doppler measuring superior mesenteric artery blood flow(mL/sec) | Preprandial Superior mesenteric artery blood flow(mL/sec) measured for 70 preterm neonate on and off non invasive ventilation. 35 preterm placed on HHHFNC in comparison to 35 preterm placed on nCPAP. | 2 years |
| D007232 | Infant, Newborn, Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D007752 | Obstetric Labor, Premature |
| D007744 | Obstetric Labor Complications |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |