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EchocardiographyNORRNENCT05462301

Normal Reference Range for Neonatal Echocardiography

An observational study of Echocardiography, run by Children's Hospital of Chongqing Medical University at 1 site in China.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Echocardiography is the main method of bedside examination of neonatal cardiac morphology, which can timely diagnose congenital heart disease and quantitatively assess its severity, but the diagnosis and evaluation process depends on the normal range of neonatal echocardiography.At present, there have been normal… Read more about this study

Who is it for?
Ages 1 day to 28 daysHealthy volunteers can take part
Conditions the study is for
Echocardiography
How many people
1,500 participants
Where
1 siteChina
Study dates
15 Nov 2022to 30 Dec 2024
Phase
Observational
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 28 days
  • All sexes
  • Healthy volunteers accepted
  • Child

Study population: healthy neonates and preterm Infants

Who may be able to join

  • Outpatient or inpatient neonate
  • Gestational age > 30weeks and birthweight > 1250 grams
  • Appropriate for gestational age
  • Without perinatal asphyxia
  • Without skin lesion on the left chest wall
  • with family informed consent for neonatal echocardiography

Who cannot join

  • specialist cardiac ultrasound suggests congenital heart disease;
  • PDA with hemodynamic abnormalities, defined as: PDA > 1.5 mm (left-to-right shunt) and left atrial diameter/aortic root > 1.5 or the need for the use of inotropes;
  • invasive mechanical ventilation therapy,
  • non-invasive mechanical ventilation with FiO2 >0.3
  • major anomalies
  • blood culture-proven neonatal sepsis
Show all 11Show fewer
  • persistent pulmonary hypertension
  • renal failure
  • necrotizing enterocolitis ≥ stage II
  • post surgery
  • Maternal history of severe anemia, or prenatal massive bleeding

Trial locations and contacts

1 site in 1 country.

Wang Jianhui, Doctor contact

+8613678428167

tonywenhui@hotmail.com

Dong Wenhui, Master contact

+8615826122681

376561086@qq.com

China1 site, 1 recruiting
  • Children's Hospital of Chongqing Medical University

    Chongqing, Chongqing Municipality, 400014

    Wang Jianhui, 13678428167, wangjh805@126.com

    Recruiting

Other trials in China

About this study

Official title: Normal Reference Range for Neonatal Echocardiography: a Multi-center, Prospective Study

Echocardiography is the main method of bedside examination of neonatal cardiac morphology, which can timely diagnose congenital heart disease and quantitatively assess its severity, but the diagnosis and evaluation process depends on the normal range of neonatal echocardiography.At present, there have been normal reference standards for echocardiography in children and adults at home and abroad, but there is no uniform standard for echocardiographic parameters in newborns, especially premature infants.This study intends to carry out a national multicenter, prospective, observational study to establish the reference range of echocardiography at different time periods after birth in newborns, and stratified according to gestational age, birth weight and gender, to conduct a more accurate hemodynamic assessment of clinically critically ill newborns and guide the treatment of critically ill newborns in real time.

Read the detailed description

Neonatal goal-directed echocardiography (TNE) performed by neonatologists has been increasingly applied to hemodynamic assessment in the NICU to guide critical neonatal treatment in real time. There are many detection indexes of TNE, which are closely related to neonatal weight, birth weight, postnatal age, race and other factors. Therefore, establishing neonatal echocardiographic reference ranges is essential for the development of TNE. At present, there have been normal reference standards for echocardiography in children and adults at home and abroad, but there is no uniform standard for echocardiographic parameters in newborns, especially premature infants. At present, there are many problems in establishing the reference range of neonatal echocardiography internationally, including the small sample size included in establishing the reference range, no premature infant standard for some parameters, the reference range is not stratified according to gender, etc. Moreover, the majority of current echocardiographic reference ranges are derived from studies in European and American populations and are not applicable to Asian patients. So far, reference ranges for neonatal echocardiography established based on high-quality clinical studies are still lacking, greatly affecting the use of echocardiography in neonatal intensive care units. Therefore, this study intends to carry out a national multicenter, prospective, observational study to establish the reference range of echocardiography at different time periods after birth in neonates, and stratify according to creatinine, birth weight and gender, providing a reference for the application of echocardiography in neonatal intensive care units, and providing an important basis for the development of TNE-centered neonatal hemodynamic comprehensive assessment program in the NICU.

  1. Study Design and Process: This study is a multicenter, prospective, observational study. Neonatal bedside echocardiography was performed by a trained neonatology clinician or sonographer. Five time points were selected for neonatal echocardiography, namely, 1 day, 3 days, 7 days, 14 days, and 28 days after birth. The examination was completed in the quiet state of the newborn, and the measurement method was based on the American Guidelines and Standards for Echocardiography in Children and the American NICU Echocardiography Practice Guidelines. All ultrasound data were averaged over three or more cardiac cycles.
  2. Sample Size Calculation: Each participating NICU will be required to enroll 300 infants (60 infants for each PNA timepoint) for a final sample size of 1500 "normal infants".
  3. Statistical Methods: Data statistics were performed using SPSS 21.0 software. The data obtained for each of the ultrasound hemodynamic parameters were tested for normality. The measurement data conforming to normal distribution are expressed by mean ± standard deviation, and the measurement data with non-normal distribution are expressed by median (interquartile range). Spearman correlation analysis was used to compare the correlation between different indicators and postnatal, birth weight, birth weight and gender. The echocardiographic reference range of newborns at different time periods after birth was established by 95% confidence interval and stratified according to birth weight, birth weight and gender. P < 0.05 was considered statistically significant.
  4. Quality control:

At the beginning of the study, a cooperative group kick-off meeting will be organized to interpret the study protocol in detail. In addition, the online or offline training of the participating units will be carried out to further unify the parameter setting and data collection criteria of the ultrasound machine. Establish a WeChat group to answer questions related to this study at any time. During the process of the project, regular contact meetings within the cooperative group will be held to ensure that the investigators participating in the study will implement the protocol. During the study, the study site will assign a special person to review the completeness and correctness of the data submitted by each participating site.

Keywords
Neonatal Echocardiogram, Reference Ranges, Preterm Infants

What participants receive

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

  • Other

    Neonatal bedside echocardiography was performed by a trained neonatologist or sonographer

What is being measured

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

  1. Changes in left atrial anteroposterior diameter with increasing age

    The Left atrial systolic anteroposterior diameter was measured by M-mode ultrasound through the aortic root in the long axis of the parasternal left ventricle

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  2. Changes in interventricular septum thickness with increasing age

    The Interventricular septal thickness was measured by left ventricular M-mode ultrasound in the long axis of the parasternal left ventricle

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  3. Changes in left ventricular posterior wall thickness at end diastole with increasing age

    The left ventricular posterior wall thickness at end diastole was measured by left ventricular M-mode ultrasound in the long axis of the parasternal left ventricle

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  4. Changes in left ventricular end diastolic diameter with increasing age

    The left ventricular end diastolic diameter was measured by left ventricular M-mode ultrasound in the long axis of the parasternal left ventricle

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  5. Changes in left ventricular end systolic diameter with increasing age

    The left ventricular end systolic diameter was measured by left ventricular M-mode ultrasound in the long axis of the parasternal left ventricle

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  6. Changes in right ventricular anteroposterior diameter at end diastole with increasing age

    The right ventricular anteroposterior diameter at end diastole was measured by left ventricular M-mode ultrasound in the long axis of the parasternal left ventricle

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  7. Changes in right ventricular outflow tract diameter with increasing age

    The right ventricular outflow tract diameter was measured in the short-axis pulmonary valve orifice view of the parasternal great arteries

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  8. Changes in left ventricular ejection fraction with increasing age

    Left ventricular ejection fraction can be calculated by measuring left ventricular end-diastolic diameter and left ventricular end-systolic diameter in a standard parasternal left ventricular long-axis view, at the level of mitral chordae tendineae, or parasternal left ventricular short-axis view, at the level of papillary muscles, with the sampling line perpendicular to the interventricular septum and left ventricular posterior wall

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

Secondary outcomes (4)
  1. Changes in left ventricular outflow tract diameter with increasing age

    In the standard parasternal long-axis view, images were frozen when the aortic valve was completely opened during systole, and the distance between the anterior and posterior aortic walls at the level of aortic root attachment was measured with an electronic cursor to obtain the left ventricular outflow tract diameter

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  2. Changes in main pulmonary artery diameter with increasing age

    In the parasternal cardiac base short-axis view, the left and right pulmonary arteries were exposed at the same time, and the diameter of the main pulmonary artery was measured

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  3. Changes in Inferior vena cava diameter with increasing age

    Inferior vena cava diameter was measured by M-mode ultrasound in the subxiphoid long-axis plane by transthoracic ultrasound

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

  4. Changes in Simpson 's method for measuring ejection fraction with increasing age

    Through the apical four-chamber view or apical two-chamber view, for the tracing of diastolic and systolic endocardium, divide the heart into several (generally 20) cylinders, calculate the volume and add them to obtain the left ventricular end-diastolic and end-systolic volumes, and then calculate the ejection fraction

    Measured: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)

Timeline

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

  1. First posted18 Jul 2022
  2. Study start15 Nov 2022
  3. Primary completion30 Dec 2024 (estimated)
  4. Study completion30 Dec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
1,500 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05462301
Sponsor's protocol ID
2022-06-10
Acronym
NORRNE
Status last verified
Jul 2024
First submitted
25 Jun 2022
Last updated
16 Jul 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • El-Khuffash A, Herbozo C, Jain A, Lapointe A, McNamara PJ. Targeted neonatal echocardiography (TnECHO) service in a Canadian neonatal intensive care unit: a 4-year experience. J Perinatol. 2013 Sep;33(9):687-90. doi: 10.1038/jp.2013.42. Epub 2013 Apr 25.

    PubMed 23619373
  • Shiraishi H, Yanagisawa M. Pulsed Doppler echocardiographic evaluation of neonatal circulatory changes. Br Heart J. 1987 Feb;57(2):161-7. doi: 10.1136/hrt.57.2.161.

    PubMed 3814451
  • Kluckow M, Evans N. Superior vena cava flow in newborn infants: a novel marker of systemic blood flow. Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F182-7. doi: 10.1136/fn.82.3.f182.

    PubMed 10794783
  • Schmitz L, Stiller B, Pees C, Koch H, Xanthopoulos A, Lange P. Doppler-derived parameters of diastolic left ventricular function in preterm infants with a birth weight <1500 g: reference values and differences to term infants. Early Hum Dev. 2004 Feb;76(2):101-14. doi: 10.1016/j.earlhumdev.2003.11.003.

    PubMed 14757262
  • Cosyns B, Lancellotti P. Normal reference values for echocardiography: a call for comparison between ethnicities. Eur Heart J Cardiovasc Imaging. 2016 May;17(5):523-4. doi: 10.1093/ehjci/jev353. Epub 2016 Mar 13. No abstract available.

    PubMed 26976356

Questions about this trial

What is this clinical trial studying?

An observational study of Echocardiography, run by Children's Hospital of Chongqing Medical University at 1 site in China.

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 6 inclusion and 11 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 16 Jul 2024. 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 China. 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 Wang Jianhui, Doctor (+8613678428167, tonywenhui@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in left atrial anteroposterior diameter with increasing age (time frame: 5 time points (1 day, 3 days, 7 days, 14 days and 28 days after birth)). The study lists 8 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 NCT05462301, which also lists 5 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 16 Jul 2024.

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