AzTrials
AzTrials

ResuscitationMONITORNCT03256578

Monitoring Neonatal Resuscitation Trial

A study testing New Life Box Respiratory Function Monitor in people with Resuscitation and Neonatal Prematurity, run by University of Pennsylvania at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is a randomized trial to determine if a visible respiratory function monitor (RFM) displaying realtime measurements of delivered inflations improves clinical providers ability to perform positive pressure ventilation (PPV) within a pre-defined target tidal volume in preterm infants after birth. Read more about this study

Who is it for?
Ages 24 to 28 weeks
What is being tested?
New Life Box Respiratory Function Monitor
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
288 participants
Where
1 siteUnited States
Study dates
20 Feb 2017to 20 Sep 2021
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 24 to 28 weeks
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Gestational age (GA) 24 - 27 6/7 weeks at birth, by best obstetrical
  • Receive positive pressure ventilation during delivery room resuscitation

Who cannot join

  • Known major anomalies including that may affect measured cardiorespiratory parameters: congenital diaphragmatic hernia, trachea-oesophageal fistula, cyanotic heart disease, pulmonary hypoplasia
  • RFM not available during resuscitation

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Hospital of the University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

Other trials in United States

About this study

Official title: A Multi-center Randomized Controlled Trial of Respiratory Function Monitoring During Stabilization of Preterm Infants at Birth

This is a randomized trial to determine if a visible respiratory function monitor (RFM) displaying realtime measurements of delivered inflations improves clinical providers ability to perform positive pressure ventilation (PPV) within a pre-defined target tidal volume in preterm infants after birth.

Read the detailed description

Recently, it has been demonstrated that the use of a respiratory function monitor (RFM) can guide PPV in the DR.(Wood, Schmolzer) In this study, the New Life Box, (Advanced Life Diagnostics, Weener, Germany) a neonatal Respiratory Monitor (RFM), will be used to measure and calculate inflation pressures, flow, and tidal volumes in all enrolled infants. The New Life Box uses a small variable orifice anemometer to measure gas flow in and out of a face-mask or endotracheal tube. This signal is automatically integrated to provide inspired (Vti) and expired (Vte) tidal volume. The difference equals the leak from the facemask or endotracheal tube. Complete airway obstruction occurs when no flow of gas into or away from the infant is seen during a positive pressure inflation. The RFM can also calculate and measure respiratory rate and minute volume, inflations and spontaneous inspirations, and all ventilation pressures. Using customized software heart rate, oxygen saturation and expired carbon dioxide can be integrated into the RFM.

The NewLife Box monitor presents graphical information for pressure, flow, and volume. In addition, the monitor displays numeric data for pressure (PIP and PEEP), tidal volume (Vti, Vte), flow, respiratory rate and percent leak. The monitor integrates and displays physiologic data streaming from the patient (heart rate and oxygen saturation) as well as FiO2 from an oxygen analyzer in the inspiratory limb of the respiratory circuit. If enabled, the monitor can incorporate video captured from an external camera. The video serves as a helpful aid in the interpretation of the events during the RFM waveform recordings.

The use of an RFM in the DR has the potential to improve neonatal respiratory support and reduce lung injury.

The primary objective of this study is to test the hypothesis that observing the data and waveforms displayed on an RFM during the provision of PPV to preterm infants (24-27 6/7 weeks gestation) after birth will increase the proportion of inflations performed with a predefined VTe "safe range" of 4 - 8 mls/kg.

Being tested
New Life Box Respiratory Function Monitor
Keywords
Resuscitation, Neonatal Prematurity, Positive-Pressure Ventilation, Respiratory Function Monitor

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • New Life Box Respiratory Function MonitorDevice

    The intervention is the use of a visible New Life Box Respiratory Function Monitor display in infants born between 24 and 27 6/7 weeks gestation receiving PPV for resuscitation after birth.

Study groups in NCT03256578
Study groupRoleWhat they receive
RFM visibleExperimentalDuring resuscitation immediately following delivery the providers involved in the care of enrolled eligible infants can see the information displayed on the New Life Box Respiratory Function Monitor screen.
Receives: Device: New Life Box Respiratory Function Monitor
RFM maskedNo interventionDuring resuscitation immediately following delivery the providers involved in the care of enrolled eligible infants cannot see the information displayed on the New Life Box Respiratory Function Monitor screen. Though the display is masked, data is collected in the background.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Positive-Pressure Ventilation Inflations Between 4 - 8 Mls/kg

    To test the hypothesis that observing the data and waveforms displayed on an RFM during the provision of PPV to preterm infants (24-27 6/7 weeks gestation) after birth will increase the percentage of inflations performed with a predefined VTe "safe range" of 4 - 8 mls/kg.

    Measured: the first 15 minutes of resuscitation

Secondary outcomes (25)
  1. Percentage of Oxygen Saturation (SpO2) in the First 5 Minutes of Life

    Median percentage of oxygen saturation (SpO2) captured on the Respiratory Function Monitor in the first 5 minutes of life

    Measured: approximately first 5 minutes of life

  2. Heart Rate in the First 10 Minutes of Life

    Median Heart rate captured on the Respiratory Function Monitor between 3 and10 minutes of life

    Measured: between 3 and 10 minutes of life

  3. Percentage of Time With Mask Leak During PPV Ventilation

    Percentage of time with significant mask leak (defined as > 60%) during the duration of PPV ventilation per infant in the first 15 minutes of resuscitation.

    Measured: approximately first 15 minutes of resuscitation

  4. Percentage of PPV Inflations With Airway Obstruction

    Percentage of PPV inflations with airway obstruction in the first 15 minutes of resuscitation. Airway obstruction is defined as Vte <1 mL/kg, with minimal mask leak (<25%) during an inflation and flattening of the flow waves.

    Measured: approximately first 15 minutes of resuscitation

  5. Percentage of PPV Inflations With Inadequate Tidal Volume

    Percentage of PPV inflations with inadequate tidal volume defined as Vte <4 ml/kg in the first 15 minutes of resuscitation.

    Measured: approximately first 15 minutes of resuscitation

  6. Percentage of Oxygen Saturation (SpO2) in the First 10 Minutes of Life

    Median percentage of Oxygen saturation (SpO2) captured on the Respiratory Function Monitor between 3 and 10 minutes of life

    Measured: Between 3 and 10 minutes of life

  7. Fraction of Inspired Oxygen (FiO2) Provided in the First 10 Minutes of Life

    Median fraction of inspired oxygen (FiO2) provided to the infant between 3 and 10 minutes of life

    Measured: between 3 and 10 minutes of life

  8. Total Duration With FiO2 of 100% Delivered in the First 10 Minutes of Life

    Total duration of time where FiO2 of 100% is delivered to the patient in first 10 minutes of life will be calculated taking into consideration birth weight, tidal volume, respiratory rate, FiO2 and timing of stabilization.

    Measured: approximately first 10 minutes of life

  9. Number of Participants Receiving Endotracheal Intubation in the Delivery Room

    Number of Participants receiving Endotracheal Intubation in the delivery room from time of birth to admission to NICU

    Measured: from time of birth to admission to NICU

  10. Number of Participants Requiring Inotropes for Circulatory Support

    Number of participants requiring inotropes for circulatory support in the Neonatal Intensive Care Unit in the first 3 days after birth

    Measured: within the first 3 days after birth

  11. Number of Participants With Pneumothorax

    Number of participants with pneumothorax in the first 72 hours after birth reported by a radiologist masked to the intervention

    Measured: in the first 72 hours after birth

  12. Number of Participants With Pulmonary Interstitial Emphysema

    Number of participants with Pulmonary Interstitial Emphysema in the first 72 hours after birth reported by a radiologist masked to the intervention

    Measured: in the first 72 hours of life

  13. Number of Participants With Abnormal Cranial Ultrasound Findings

    Number of participants with abnormal cranial ultrasound findings (i) all intraventricular hemorrhage, (ii) severe - ie. Papile grade III and IV intraventricular hemorrhage, (iii) cystic periventricular leukomalacia through study completion, an average of 4 months

    Measured: through study completion, an average of 4 months

  14. Duration of Endotracheal Ventilation

    Duration of endotracheal (ET) ventilation days through study completion, an average of 4 months

    Measured: days through study completion, an average of 4 months

  15. Duration of Non-invasive Ventilation

    Duration of non-invasive ventilation, days through study completion, an average of 4 months

    Measured: days through study completion, an average of 4 months

  16. Duration of Supplemental Oxygen Therapy

    Duration of supplemental oxygen therapy days through study completion, an average of 4 months

    Measured: days through study completion, an average of 4 months

  17. Total Duration of Assisted Ventilation

    Total duration of assisted ventilation (ET, CPAP) in hours through study completion, an average of 4 months

    Measured: through study completion, an average of 4 months

  18. Number of Participants With a Diagnosis of Bronchopulmonary Dysplasia

    Number of participants with a diagnosis of bronchopulmonary dysplasia (BPD) at 36 weeks corrected gestational age defined as the need for supplementary oxygen and/or any form respiratory support

    Measured: at 36 weeks corrected gestational age

  19. Neonatal Mortality

    Neonatal mortality from the time of birth until hospital discharge or 44 weeks corrected gestational age, whichever occurred first

    Measured: from time of birth until discharge from hospital, up to 44 weeks corrected gestational age

  20. Composite Outcome of Death or BPD

    Composite outcome of death or BPD. BPD assessed at corrected gestational age of 36 weeks; death assessed from time of birth until discharge, up to 44 weeks corrected gestational age

    Measured: BPD assessed at corrected gestational age of 36 weeks; death assessed from the time of birth until hospital discharge or 44 weeks corrected gestational age, whichever occurred first

  21. Number of Participants With Retinopathy of Prematurity Requiring Treatment

    Number of participants with Retinopathy of prematurity requiring treatment before hospital discharge, an average of 4 months

    Measured: before hospital discharge, an average of 4 months

  22. Number of Participants With a Diagnosis of Necrotizing Enterocolitis

    Number of participants with a diagnosis of Necrotizing enterocolitis grade 2 or more before hospital discharge, an average of 4 months

    Measured: before hospital discharge, an average of 4 months

  23. Number of Participants Requiring Fluid Boluses for Circulatory Support

    Number of participants requiring fluid boluses for circulatory support in the Neonatal Intensive Care Unit within the first 3 days of life

    Measured: within the first 3 days of life

  24. Number of Participants With Endotracheal Intubation in the NICU

    Number of Participants with Endotracheal Intubation in the NICU in the first 24 hours of life

    Measured: in the first 24 hours of life

  25. Neonatal Mortality in the Delivery Room

    Neonatal Mortality in the delivery room from time of birth until transfer to NICU

    Measured: from time of birth until transfer to NICU

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Aug 2017
  2. Study start20 Feb 2017
  3. Primary completion17 May 2019
  4. Study completion20 Sep 2021

Resources

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
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
Eligible infants are either randomized to the intervention, where the clinical team will be able to directly observe the monitor or randomized to the RFM-masked display arm, where they will only see a black screen.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
288 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03256578
Sponsor's protocol ID
826695
Other IDs
NTR4104
Acronym
MONITOR
Status last verified
Nov 2021
First submitted
15 Aug 2017
Last updated
22 Nov 2021
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Wood FE, Morley CJ, Dawson JA, Davis PG. A respiratory function monitor improves mask ventilation. Arch Dis Child Fetal Neonatal Ed. 2008 Sep;93(5):F380-1. doi: 10.1136/adc.2007.120097. Epub 2008 Jan 11.

    PubMed 18192329
  • Schmolzer GM, Kamlin OC, Dawson JA, te Pas AB, Morley CJ, Davis PG. Respiratory monitoring of neonatal resuscitation. Arch Dis Child Fetal Neonatal Ed. 2010 Jul;95(4):F295-303. doi: 10.1136/adc.2009.165878. Epub 2009 Sep 22.

    PubMed 19776023
  • van Zanten HA, Kuypers KLAM, van Zwet EW, van Vonderen JJ, Kamlin COF, Springer L, Lista G, Cavigioli F, Vento M, Nunez-Ramiro A, Oberthuer A, Kribs A, Kuester H, Horn S, Weinberg DD, Foglia EE, Morley CJ, Davis PG, Te Pas AB. A multi-centre randomised controlled trial of respiratory function monitoring during stabilisation of very preterm infants at birth. Resuscitation. 2021 Oct;167:317-325. doi: 10.1016/j.resuscitation.2021.07.012. Epub 2021 Jul 22.

    PubMed 34302924

Questions about this trial

What is this clinical trial studying?

A study testing New Life Box Respiratory Function Monitor in people with Resuscitation and Neonatal Prematurity, run by University of Pennsylvania at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Jan 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Positive-Pressure Ventilation Inflations Between 4 - 8 Mls/kg (time frame: the first 15 minutes of resuscitation). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03256578, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Nov 2021.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in