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Respiratory Function TestsiFOTNCT04697251

Infant Forced Oscillations Technique (iFOT)

A study testing FOT measurements in newborns and small infants in people with Respiratory Function Tests and Respiratory Disease, run by University of Patras at 2 sites in Greece.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The aim of this study is the implementation of Forced Oscillations Technique (FOT) in newborns and small infants using a novel commercially available device. The objective is to assess the feasibility of the method, provide normative data for the first months of life and describe short- and long-term changes in… Read more about this study

Who is it for?
Ages 1 day to 12 monthsHealthy volunteers can take part
What is being tested?
FOT measurements in newborns and small infants
Could I receive a placebo?
No, everyone receives an active treatment
How many people
350 participants
Where
2 sitesGreece
Study dates
1 Apr 2021to Mar 2023
Phase
Interventional
Are there results?
None posted in the registry

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 1 day to 12 months
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Newborns cared for in the NICU and well-baby nursery of the University Hospital of Patras, Greece.
  • Parental written informed consent.

Who cannot join

  • Major respiratory, cardiovascular or other condition that does not permit FOT measurements at the predetermined time points.
  • Any infectious disorder with increased risk of contamination.
  • Orofacial anomalies (e.g. genetic syndromes) that do not permit proper application of the face mask.

Trial locations and contacts

2 sites in 1 country.

Sotirios Fouzas, MD, PhD contact

6944510047

sfouzas@upatras.gr

Gabriel Dimitriou, MD, PhD contact

gdim@upatras.gr

Greece2 sites, 2 recruiting
  • Neonatal Intensive Care Unit, University Hospital of Patras

    Pátrai, 26504

    Gabriel Dimitriou, MD, PhD, gdim@upatras.gr

    Sotirios Fouzas, MD, PhD, 6944510047, sfouzas@upatras.gr

    Recruiting
  • Well-baby nursery, Department of Pediatrics, University Hospital of Patras

    Pátrai, 26504

    Gabriel Dimitriou, MD, PhD, gdim@upatras.gr

    Sotirios Fouzas, MD, PhD, 6944510047, sfouzas@upatras.gr

    Recruiting

Other trials in Greece

About this study

Official title: Application of Forced Oscillation Technique in Infancy

The aim of this study is the implementation of Forced Oscillations Technique (FOT) in newborns and small infants using a novel commercially available device.

The objective is to assess the feasibility of the method, provide normative data for the first months of life and describe short- and long-term changes in neonatal respiratory disorders.

Read more

The study population will consist of term and preterm newborns admitted to the Neonatal Intensive Care Unit (NICU) or the Well-Baby Nursery of the University Hospital of Patras, Greece. It is estimated that 200 full-term and 150 preterm newborns will be enrolled during a period of 36 months (March 2021 - September 2022).

Measurements will be performed using the TremoFlo N-100 via a face mask, with the infant in the supine position during natural sleep. At least 3 technically acceptable measurements (duration 10s each) will be obtained, as follows:

  • Healthy full-term neonates: postnatal days 1, 2, 3 and at discharge
  • Preterm neonates: NICU admission, postnatal days 1, 2 and 3, and on the first day of each additional gestational week until discharge

All participants will be also measured at the age of 3, 6 and 12 months.

Read the detailed description

INTRODUCTION Pulmonary function testing during early infancy requires sophisticated equipment, specialized personnel and proper patient's preparation. As a result, lung function testing in newborns and small infants is limited to few highly specialized centers.

The forced oscillations technique (FOT) uses complex pressure signals generated by an external device at the airway opening. The pressure waves are transmitted through the airway tree during tidal breathing and force the anatomical structures of the respiratory system to oscillate. From subsequent pressure and flow signal analysis, the total resistance (Rrs) and reactance (Xrs) of the respiratory system are calculated. The latter relates mainly to the elastic properties of the lung parenchyma and the inertia of the column of air in the airways. Both Rrs and Xrs depend on the frequency of oscillation; lower frequencies (range 5-10Hz) provide information on the mechanical properties of smaller airways and vice versa. FOT measurements can be performed fast (usually in less than 30 s), at the bedside, and do not require patient's cooperation. Therefore, FOT is being viewed as an attractive and promising pulmonary function technique for young infants and newborns.

To date, the introduction of infant FOT in routine clinical practice has been limited due to lack of suitable devices and normative data. Studies based on in-build FOT equipment have shown that the application of the method in small infants is feasible. A recent study, in which a modified commercially available device (Tremoflo C-100, THORASYS Thoracic Medical Systems Inc. Montreal, Canada) was used, also supports the feasibility of the method.

OBJECTIVE The aim of this study is the implementation of FOT in newborns and small infants using a novel commercially available device (Tremoflo N-100, THORASYS), specifically released for this age range.

Our objectives are: a) to assess the feasibility of the method and the repeatability of FOT measurements in newborns and small infants, b) to provide normative data for the first months of life in relation to various parameters (e.g. gender, age, somatometrics, etc) and, c) to describe short- and long-term and Rrs and Xrs changes in neonatal respiratory disease (e.g. respiratory distress syndrome, bronchopulmonary dysplasia, etc).

METHODS Population The study population will consist of term and preterm newborns admitted to the Neonatal Intensive Care Unit (NICU) or the Well-Baby Nursery of the University Hospital of Patras, Greece. It is estimated that 200 full-term and 150 preterm newborns will be enrolled during a period of 36 months (March 2021 - September 2022).

The parents of all infants will provide written informed consent prior to enrollment. The study has been approved by the Research and Ethics Committee of the hospital (decision no. 451/12.11.2020).

Measurements Measurements will be performed using the TremoFlo N-100, at bedside, with the infant in the supine position during quiet natural sleep. The device will be calibrated daily, according to manufacturer's instructions. After proper cleaning and decontamination, the face mask of the device will be preheated at 37oC (to avoid awakening) and will be placed on infant's face. The duration of each measurement will be predetermined at 10 s. At least 3 technically acceptable measurements will be performed per infant, with 30 s intervals between them. The validity of each measurement will be assessed according to the coherence function (automatically determined by the operating system of the device).

Protocol

FOT measurements will be scheduled according to the target population, as follows:

  • In healthy full-term neonates, measurements will be obtained on postnatal days 1, 2, 3 and at discharge. Parents will be asked and scheduled to repeat testing at the age of 3, 6 and 12 months.
  • In preterm neonates without respiratory disease, measurements will be performed on NICU admission, on postnatal days 1, 2 and 3, and on the first day of each additional gestational week until discharge. For example, a preterm neonate with gestational age 331/7, will be measured at 331/7, 332/7, 333/7, 334/7, 34, 35, 36, etc. Parents of preterm newborns will be also asked and scheduled to repeat testing at the age of 3, 6 and 12 months.
  • In preterm neonates with respiratory distress syndrome (RDS) the measurements will be obtained on NICU admission and at 6 and 12 hours after surfactant administration. Thereafter, the same protocol with preterm neonates without respiratory disease will be applied. In mechanically ventilated infants the measurements will be performed via the endotracheal tube, but only if their clinical condition permits FOT testing. In such cases, the device will be calibrated in advance using an endotracheal tube of the same internal diameter, material and length as that positioned on the neonate.

EXPECTED RESULTS AND BENEFITS The study is expected to confirm the feasibility of FOT in newborns and small infants (in NICU or outpatient settings) and, most important, to reveal a series of technical/practical details that may improve the applicability of the method in clinical practice. Finally, the study will provide normative data for this age range, and will assess Rrs and Xrs changes in various respiratory disorders of the neonatal period and early infancy.

Being tested
FOT measurements in newborns and small infants
Medical subject headings
Respiration Disorders, Disease

What participants receive

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

  • FOT measurements in newborns and small infantsDiagnostic test

    Measurements will be performed using the device TremoFlo N-100, at bedside, with the infant in the supine position during quiet natural sleep. After proper cleaning and decontamination, the face mask of the device will be preheated at 37oC (to avoid awakening) and will be placed on infant's face. The duration of each measurement will be predetermined at 10 s. At least 3 technically acceptable measurements will be performed per infant, with 30 s intervals between them. The validity of each measurement will be assessed according to the coherence function (automatically determined by the operating system of the device).

Study groups in NCT04697251
Study groupRoleWhat they receive
FOT measurementsOtherFOT measurements in newborns and small infants
Receives: Diagnostic Test: FOT measurements in newborns and small infants

What is being measured

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

  1. Respiratory resistance (Rrs) - Term newborns

    Rrs at multiple frequencies (FOT) in term infants

    Measured: Postnatal day 1.

  2. Respiratory resistance (Rrs) - Term newborns

    Rrs at multiple frequencies (FOT) in term infants

    Measured: Postnatal day 2.

  3. Respiratory resistance (Rrs) - Term newborns

    Rrs at multiple frequencies (FOT) in term infants

    Measured: Postnatal day 3.

  4. Respiratory resistance (Rrs) - Term newborns

    Rrs at multiple frequencies (FOT) in term infants

    Measured: On the day of discharge.

  5. Respiratory reactance (Xrs) - Term newborns

    Xrs at multiple frequencies (FOT) in term infants

    Measured: Postnatal day 1.

  6. Respiratory reactance (Xrs) - Term newborns

    Xrs at multiple frequencies (FOT) in term infants

    Measured: Postnatal day 2.

  7. Respiratory reactance (Xrs) - Term newborns

    Xrs at multiple frequencies (FOT) in term infants

    Measured: Postnatal day 3.

  8. Respiratory reactance (Xrs) - Term newborns

    Xrs at multiple frequencies (FOT) in term infants

    Measured: On the day of discharge

  9. Respiratory resistance (Rrs) - Preterm newborns

    Rrs at multiple frequencies (FOT) in preterm infants

    Measured: At NICU admission (within the first 2 hours).

  10. Respiratory resistance (Rrs) - Preterm newborns

    Rrs at multiple frequencies (FOT) in preterm infants

    Measured: Postnatal day 1.

  11. Respiratory resistance (Rrs) - Preterm newborns

    Rrs at multiple frequencies (FOT) in preterm infants

    Measured: Postnatal day 2.

  12. Respiratory resistance (Rrs) - Preterm newborns

    Rrs at multiple frequencies (FOT) in preterm infants

    Measured: Postnatal day 3.

  13. Respiratory resistance (Rrs) - Preterm newborns

    Rrs at multiple frequencies (FOT) in preterm infants

    Measured: On the first day of each additional week until 36 weeks post-conceptional age.

  14. Respiratory resistance (Rrs) - Preterm newborns

    Rrs at multiple frequencies (FOT) in preterm infants

    Measured: On the day of discharge.

  15. Respiratory reactance (Xrs) - Preterm newborns

    Xrs at multiple frequencies (FOT) in preterm infants

    Measured: At NICU admission (within the first 2 hours).

  16. Respiratory reactance (Xrs) - Preterm newborns

    Xrs at multiple frequencies (FOT) in preterm infants

    Measured: On postnatal day 1.

  17. Respiratory reactance (Xrs) - Preterm newborns

    Xrs at multiple frequencies (FOT) in preterm infants

    Measured: On postnatal day 2.

  18. Respiratory reactance (Xrs) - Preterm newborns

    Xrs at multiple frequencies (FOT) in preterm infants

    Measured: On postnatal day 3.

  19. Respiratory reactance (Xrs) - Preterm newborns

    Xrs at multiple frequencies (FOT) in preterm infants

    Measured: On the first day of each additional week until 36 weeks post-conceptional age.

  20. Respiratory reactance (Xrs) - Preterm newborns

    Xrs at multiple frequencies (FOT) in preterm infants

    Measured: On the day of discharge.

  21. Respiratory resistance (Rrs) - Infancy

    Rrs at multiple frequencies (FOT) during infancy

    Measured: At the age of 3 months (+/- 1 week)

  22. Respiratory resistance (Rrs) - Infancy

    Rrs at multiple frequencies (FOT) during infancy

    Measured: At the age of 6 months (+/- 1 week)

  23. Respiratory resistance (Rrs) - Infancy

    Rrs at multiple frequencies (FOT) during infancy

    Measured: At the age of 12 months (+/- 2 weeks)

  24. Respiratory reactance (Xrs) - Infancy

    Xrs at multiple frequencies (FOT) during infancy

    Measured: At the age of 3 months (+/- 1 week)

  25. Respiratory reactance (Xrs) - Infancy

    Xrs at multiple frequencies (FOT) during infancy

    Measured: At the age of 6 months (+/- 1 week)

  26. Respiratory reactance (Xrs) - Infancy

    Xrs at multiple frequencies (FOT) during infancy

    Measured: At the age of 12 months (+/- 2 weeks)

Timeline

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

  1. First posted6 Jan 2021
  2. Study start1 Apr 2021
  3. Primary completionSep 2022 (estimated)
  4. Study completionMar 2023 (estimated)

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
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
350 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04697251
Sponsor's protocol ID
28292/20201103
Acronym
iFOT
Status last verified
Apr 2021
First submitted
2 Jan 2021
Last updated
28 Apr 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: No Ethics Committee approval

Publications

  • Skylogianni E, Douros K, Anthracopoulos MB, Fouzas S. The Forced Oscillation Technique in Paediatric Respiratory Practice. Paediatr Respir Rev. 2016 Mar;18:46-51. doi: 10.1016/j.prrv.2015.11.001. Epub 2015 Nov 10.

    PubMed 26777151
  • Hantos Z, Czovek D, Gyurkovits Z, Szabo H, Maar BA, Radics B, Virag K, Makan G, Orvos H, Gingl Z, Sly PD. Assessment of respiratory mechanics with forced oscillations in healthy newborns. Pediatr Pulmonol. 2015 Apr;50(4):344-52. doi: 10.1002/ppul.23103. Epub 2014 Aug 25.

    PubMed 25154334
  • Gray DM, Czovek D, McMillan L, Turkovic L, Stadler JAM, Vanker A, Radics BL, Gingl Z, Hall GL, Sly PD, Zar HJ, Hantos Z. Intra-breath measures of respiratory mechanics in healthy African infants detect risk of respiratory illness in early life. Eur Respir J. 2019 Jan 31;53(2):1800998. doi: 10.1183/13993003.00998-2018. Print 2019 Feb.

    PubMed 30464010
  • Klinger AP, Travers CP, Martin A, Kuo HC, Alishlash AS, Harris WT, Carlo WA, Ambalavanan N. Non-invasive forced oscillometry to quantify respiratory mechanics in term neonates. Pediatr Res. 2020 Aug;88(2):293-299. doi: 10.1038/s41390-020-0751-7. Epub 2020 Jan 14.

    PubMed 31935746

Questions about this trial

What is this clinical trial studying?

A study testing FOT measurements in newborns and small infants in people with Respiratory Function Tests and Respiratory Disease, run by University of Patras at 2 sites in Greece.

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 3 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: status not confirmed, as of the sponsor's last update on 28 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Greece. 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?

Results are not available in the source record.

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

Contact Sotirios Fouzas, MD, PhD (6944510047, sfouzas@upatras.gr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Respiratory resistance (Rrs) - Term newborns (time frame: Postnatal day 1.). The study lists 26 primary outcomes in all. 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 NCT04697251, which also lists 4 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 28 Apr 2021.

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