Hypothermia NeonatalNCT03031431
Electricity-free Infant Warmer for Newborn Thermoregulation in Rwanda
A study testing Non-Electric Infant Warmer in people with Hypothermia Neonatal, run by Boston Children's Hospital at 1 site in Rwanda.
Trial summary
Hypothermia contributes to a significant portion of neonatal deaths. Kangaroo mother care (KMC) is a safe and effective method of warming; however, it is not always feasible, and not possible in settings such as resuscitation or clinical instability. Read more about this study
- Who is it for?
- Ages Up to 3 months
- Conditions the study is for
- Hypothermia Neonatal
- What is being tested?
- Non-Electric Infant Warmer
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 130 participants
- Where
- 1 siteRwanda
- Study dates
- Jul 2016to Jul 2019
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 3 months
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Any infant with the following criteria for whom caregiver is not available for Kangaroo Mother Care, or Kangaroo Mother Care is not adequate (less than ½ degree Celsius per hour rise in temperature).
- axillary temperature < 36 degrees C and ≥35 degrees C 1a) If an electric warmer is available and the infant's temperature is < 35 degrees C, then the infant would start by being warmed on the electric warmer until the infant's temperature reaches 36 degrees C, then can start non-electric infant warmer use
- Infants at-risk for hypothermia (criteria: estimated post-menstrual age of < 35 weeks or current body weight of < 2.5 kg)
Who cannot join
- Any infant whose family is unwilling to consent to study.
- Mothers who are critically ill at the time of infant eligibility or deemed not medically stable by nursing staff to be approached for consent.
- Any infant with a contraindication to Kangaroo Mother Care (medical instability) and electrical heating source available.
- Any infant with initial temperature < 35 degrees C and electrical heating source available.
- Infants within the first hour of admission to neonatal unit or first hour of life in maternity.
- Infants requiring phototherapy
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- Infants with significant skin condition
- Infants with Hypoxic Ischemic Encephalopathy (HIE)
- Stopping Criteria:
- If an electric heating source is available, the infant will be taken off the study and warmed with an appropriate source of electric heat if the infant:
- Is hypothermic and temperature decreases on any measurement
- Is hypothermic and temperature does not begin to rise within 30 minutes
- Is hypothermic and not heating at a rate of > ½ degree C per hour until temperature is >36.5 degrees C
- Has a temperature that falls below 36 degrees C despite maximum exposure to the heat source
- Is ever considered to be too severely ill by the medical team to be safely cared for in the non-electric infant warmer.
- The warmer will be removed once its temperature drops below 36 degrees, and/or the phase change material begins to harden.
Trial locations and contacts
1 site in 1 country.
About this study
Hypothermia contributes to a significant portion of neonatal deaths. Kangaroo mother care (KMC) is a safe and effective method of warming; however, it is not always feasible, and not possible in settings such as resuscitation or clinical instability. Electric warmers are the standard of care in developed countries, but are extremely costly, complicated with risk of causing both hypo and hyperthermia with misuse, and often not feasible in settings without stable electricity. Through a multi-institutional collaboration, the investigators have developed an electricity-free infant warmer. After laboratory based prototype testing for safety and efficacy, the investigators aim to study the supervised use of the warmer under routine implementation conditions in a resource-limited setting.
Read the detailed description
Hypothermia contributes to a significant portion of neonatal deaths. Kangaroo mother care (KMC) is a safe and effective method of warming; however, it is not always feasible, and not possible in settings such as resuscitation or clinical instability. Electric warmers are the standard of care in developed countries, but are extremely costly, complicated with risk of causing both hypo and hyperthermia with misuse, and often not feasible in settings without stable electricity. Through a multi-institutional collaboration, the investigators have developed an electricity-free infant warmer. After laboratory based prototype testing for safety and efficacy, the investigators aim to study the supervised use of the warmer under routine implementation conditions in a resource-limited setting. The primary aim of Phase 1 is to determine if the infant warmer is a safe, effective, usable and functional addition to KMC. This is planned in a convenience sample of patients in two district hospitals, one in a relatively warm environment, and one in a colder setting using quantitative methods and observer audits of usability and functionality. After determination of safety and effectiveness and making any necessary modifications to the warmer, Phase 2 aims to study the warmer in rural health centers and transport, as this is where we ultimately aim to use the electricity free devices due to the limited access to functioning and stable electricity in these settings. The overall goal of the project is dissemination of the study results, and ultimately the infant warmer to the district and national level for key policy makers and stakeholders, as well as globally via publication.
- Conditions
- Hypothermia Neonatal
- Being tested
- Non-Electric Infant Warmer
- Keywords
- Hypothermia, Infant Warmer
- Medical subject headings
- Hypothermia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Non-Electric Infant WarmerDevice
Electric warmers are the standard of care in developed countries, but are extremely costly, complicated with risk of causing both hypo and hyperthermia with misuse, and often not feasible in settings without stable electricity. Through a multi-institutional collaboration, the investigators have developed an electricity-free infant warmer.
| Study group | Role | What they receive |
|---|---|---|
| Non-Electric Infant Warmer | Experimental | In line with current recommended practice, mothers will be encouraged to provide Kangaroo Mother Care (KMC) whenever possible. If an infant's temp is not rising by ½ degree C per hour with KMC alone, the infant warmer will be offered as an addition by the study team. If the mother is not available for KMC at any time, the infant will be warmed exclusively with the warmer. Bundling in clothes will only be used in addition to the warmer per carer preference. Temp measurement of the infant, warmer, and ambient air will be measured every 15 mins for the first hr, then hrly and as needed for the remainder of use or until warmer endpoint is reached (warmer temp below 36 degrees or phase-change material hardens [soft, semisoft, or hardened]). Receives: Device: Non-Electric Infant Warmer |
What is being measured
The primary outcome is the main question the study is designed to answer.
Temperature/Effectiveness
The infant warmer will be evaluated on the number of time is able to successfully achieve and maintain a normal body temperature for patients who are hypothermic and those patients at risk of hypothermia because of a < 2.5 kg birth weight or < 35 week gestational age.
Measured: Up to 6 months
Secondary outcomes (3)
Usability
The investigators will use observation to evaluate the usability of the warmer by assessing whether or not the infant warmer was used in a way that deviated from its recommended use.
Measured: Up to 6 months
Functionality
The functionality will be assessed by whether or not there appeared to be wear and tear on the infant warmer based on repeated use.
Measured: Up to 6 months
Qualitative Survey
The same as primary outcome and secondary outcome as described above with the setting being clinic and transport based rather than in a hospital, and with the addition of qualitative questions for mother and nurse regarding infant warmer use.
Measured: Up to 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Jan 2017 (estimated)
- Study startJul 2016
- Primary completionDec 2018
- Study completionJul 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Hypothermia NeonatalStudies of the same condition, open and under way.
- More trials run by Boston Children's HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 130 participants (actual)
Sponsor and investigators
- Lead sponsor
- Boston Children's Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Ministry of Health, Rwanda, Rwandan Biomedical Counsel (RBC), Harvard Medical School (HMS and HSDM), Institute for Transformative Technologies (ITT), Brigham and Women's Hospital, Partners in Health
- Responsible party
- Principal investigator, Anne Hansen, Boston Children's Hospital
- Investigators
- Anne Hansen, MD, Principal investigator, Boston Children's Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03031431
- Sponsor's protocol ID
- IRB-P00016205
- Status last verified
- Jan 2020
- First submitted
- 13 Dec 2016
- Last updated
- 13 Jan 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- No