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Extremely Low Birthweight InfantVolemNCT06334523

Ventilation of the Extremely Premature Infants Optimized by Dead Space Washout

A study testing Ventilation with Dead Space Washout via Continuous Tracheal Gas Insufflation (CTGI) in people with Extremely Low Birthweight Infant and Continuous Tracheal Gas Insufflation, run by Centre Hospitalier Intercommunal Creteil at 4 sites in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

The Continuous Tracheal Gas Insufflation (CTGI) is a ventilation option of conventional mechanical ventilation that is used to reduce or even eliminate the dead space caused by respiratory prostheses. Read more about this study

Who is it for?
Ages Up to 7 days
What is being tested?
Ventilation with Dead Space Washout via Continuous Tracheal Gas Insufflation (CTGI)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
144 participants
Where
4 sitesFrance
Study dates
13 Feb 2025to 3 Apr 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

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 7 days
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Gestational Age at birth between 23 weeks gestation + 0 days and 26 weeks gestation + 6days
  • Age between 0 and 7 days of life
  • Need for intubation and mechanical ventilation before day 8 of life
  • Availability of the Research-associated medical devices
  • Beneficiary of a social security system (in France: CMU or securité sociale)
  • Parental consent for their infant to participate in this trial

Who cannot join

  • Known Severe Congenital Malformation (potential life-threatening malformation)
  • Known Preexisting Severe Intraventricular Haemorrhage (grade 3 or 4) and/or other brain abnormality that can alter life prognosis
  • Known Genetic Disorder (potential life-threatening malformation)
  • Preexistent mechanical ventilation for a duration of more than 12 hours
  • Participation in another interventional research trial before inclusion

Trial locations and contacts

4 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Claude Danan, M.D. contact

+33609187562

claude.danan@chicreteil.fr

Camille Jung, MD, PhD contact

+33157022268

camille.jung@chicreteil.fr

France4 sites
  • Centre Hospitalier Intercommunal de Creteil

    Créteil, 94010

    Fabrice Decobert, MD, +33, fabrice.decobert@chicreteil.fr

    laurence caeymaex, MD PhD, +33664095607, laurence.caeymaex@gmail.com

  • Centre Hospitalier Universitaire de Nantes

    Nantes, 44000

    Cyril Flamant, MD PhD, +33240083483, cyril.flamant@chu-nantes.fr

    Geraldine Apprioual, MD, +33240083483, geraldine.apprioual@chu-nantes.fr

  • Centre Hopistalier Universitaire Cochin Port Royal aphp

    Paris, 75014

    Juliana Patkai, MD, +33158413645, juliana.patkai@aphp.fr

    Juliana Patkai, MD

  • Centre hospitalier Robert Debré aphp

    Paris, 75019

    Valerie Biran, MD PhD, +33140034191, valerie.biran@aphp.fr

    Nizar Khattat, MD, +33140031331, nizar.khattat@aphp.fr

Other trials in France

About this study

Official title: Open Randomised Study of Conventional Ventilation Optimised by Dead Space Washout in Extremely Premature Infants

The Continuous Tracheal Gas Insufflation (CTGI) is a ventilation option of conventional mechanical ventilation that is used to reduce or even eliminate the dead space caused by respiratory prostheses. This objective is of particular interest in the smallest preterm infants, where the volume of anatomical dead space due to prostheses is little different from the tidal volume. The principle of this option is to continuously blow an additional flow of 0.2 L/minute at the tip of the endotracheal tube to purge expired CO2 trapped in the prostheses, to have a CO2-free volume of gas available for subsequent insufflation.

The goal of this clinical trial is to learn if Continuous Tracheal Gas Insufflation (CTGI) works to reduce ventilatory dependence in preterm infants after mechanical ventilation. It will also learn about the safety of CTGI. The main questions it aims to answer are:

Read more
  • Does Continuous Tracheal Gas Insufflation (CTGI) reduce the number of days of non-invasive ventilation in extremely preterm infants who needed mechanical ventilation?
  • Does Continuous Tracheal Gas Insufflation (CTGI) reduce the age at the weaning of any ventilatory support and/or oxygen supplementation.

Researchers will compare the clinical outcome of patients mechanically ventilated with the CTGI-device to the outcome of patients ventilated without the CTGI device, to see if the CTGI ventilation works to reduce ventilation dependence.

Participants will:

  • Be mechanically ventilated using CTGI (if randomly assigned in the CTGI-group), for the entire endotracheal ventilation period during their stay in the neonatal intensive care unit.
Being tested
Ventilation with Dead Space Washout via Continuous Tracheal Gas Insufflation (CTGI)
Keywords
lung protection, extremely low birthweight infant, Ventilator-Induced Lung Injury, mechanical ventilation
Medical subject headings
Ventilator-Induced Lung Injury

What participants receive

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

  • Ventilation with Dead Space Washout via Continuous Tracheal Gas Insufflation (CTGI)Device

    Also called Continuous Tracheal Gas Insufflation, CTGI

    The intervention involves adding a device which allows CTGI (the "CTGI-device") to washout the dead space in preterm mechanically ventilated infants. Dead space washout using the CTGI-device is an option added to standard ventilation, to reduce or even cancel anatomical dead space due to respiratory prostheses in intubated preterm infants.

Study groups in NCT06334523
Study groupRoleWhat they receive
Continuous Tracheal Gas InsufflationExperimentalthe preterm infant intubated and ventilated with Continuous Tracheal Gas Insufflation
Receives: Device: Ventilation with Dead Space Washout via Continuous Tracheal Gas Insufflation (CTGI)
Standard ventilation without CTGINo interventionIn the No Intervention arm, the preterm infants are mechanically ventilated using standard ventilation, without the CTGI-device. There is no dead space washout.

What is being measured

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

  1. Cumulative duration of all periods of non-invasive ventilation

    The cumulative duration of all periods of non-invasive ventilation, in days, starting from birth, and up to maximum 45 weeks corrected gestational age. Non-invasive ventilation includes all types of positive pressure support non-invasive ventilation and high flow nasal cannula ventilation (HFNC).

    Measured: From birth to the end of hospital stay, up to maximum 45 weeks of corrected gestational age.

Secondary outcomes (32)
  1. Number of participants deceased

    For each arm: mortality rate during initial hospitalization.

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  2. Measure of the Driving Pressure during mechanical ventilation

    Mean Driving pressure (∆P: Ppeak-PEEP) collected each 12 hours for all patients on invasive mechanical ventilation.

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  3. Measure of expiratory tidal volume during mechanical ventilation.

    Mean expiratory tidal volume (VT) collected each 12 hours for all patients on invasive mechanical ventilation.

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  4. Measure of carbon dioxide partial pressure (PCO2) on blood gas

    Carbon dioxide partial pressure (PCO2) on patient's blood gas during mechanical ventilation

    Measured: From enrollment up to maximum 15 days of life

  5. Measure of Transcutaneous Carbon dioxide partial pressure (TcPCO2)

    Transcutaneous measure of Carbon dioxide partial pressure (TcPCO2) collected each 12 hours during mechanical ventilation.

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  6. Number of participants who received a second dose of surfactant

    Rates of patients with more than one dose of surfactant replacement therapy.

    Measured: From birth up to maximum 7 days of life.

  7. Number of participants treated with high-frequency ventilation (HFV) or high-frequency oscillatory ventilation (HFOV).

    Rates of patients treated with High Frequency ventilation (HFV) or High frequency oscillatory ventilation (HFOV) during invasive mechanical ventilation.

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  8. Use of Inhaled Nitric Oxide (iNO therapy)

    Rates of patients treated with nitric oxyde (iNO) during invasive mechanical ventilation.

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  9. Number of participant with Severe hypoxemia

    Rates of patients with Oxygenation Index ≥ 10

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  10. Number of participants treated for Pneumothorax

    Rates of patients with treated Pneumothorax (Needle Thoracentesis or Chest Drainage)

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  11. Number of participants treated with Systemic Corticosteroids for Prevention or Management of Bronchopulmonary Dysplasia (BPD)

    Rates of patients treated with systemic corticosteroids for the prevention or management of BPD and number of days of treatment, excluding prophylactic hydrocortisone treatment in the first 10 days of life.

    Measured: From enrollment to the date of the end of the hospital stay, up to maximum 5 months of life

  12. Number of participants diagnosed as Bronchopulmonary Dysplasia (BPD)

    Rates of patients with Bronchopulmonary Dysplasia (BPD) diagnosed at 36 weeks of corrected gestational age.

    Measured: From two days before 36 weeks of corrected gestational age until two days after 36 weeks of corrected gestational age..

  13. Number of participants with unplanned extubation

    Rates of unplanned extubations per 100 ventilator days, and context.

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  14. Calculation of days with invasive mechanical ventilation for each participant.

    Number of days spent on invasive mechanical ventilation

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  15. Calculation of the mean age at definitive weaning from invasive ventilation for the participants in each arm.

    Age at total weaning from invasive mechanical ventilation

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  16. Age of participants at definitive weaning from all positive pressure ventilatory support

    The age in days when the infant is definitively weaned from invasive and non-invasive positive pressure ventilation, excluding High Flow Nasal Canula (HFNC) and Low Flow Nasal Canula ventilation (LFNC).

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  17. Age of the participants at the definitive withdrawal of any Ventilatory Support

    The age in days when the infant is definitively weaned from invasive and non-invasive ventilation, including High-Flow Nasal Cannula (HFNC). This excludes Low-Flow Nasal Cannula (LFNC), with or without supplemental oxygen delivery.

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  18. Age of the participants at definitive O2 weaning.

    The age in days when the patient is definitively weaned from oxygen supplementation. This includes being weaned from any respiratory support system, as well as from Low-Flow Nasal Cannula, with or without supplemental oxygen delivery.

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  19. Number of participants with Late-onset primary bloodstream infections

    Rates of Late-onset primary bloodstream infections using CDC surveillance definitions, calculated for 1000 central-line days.

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  20. Number of participants with Neuroimaging complications

    Rates of acquired neuroimaging complications: Periventicular Leucomalacia, Cerebellar haemorrhage, Intra-Ventricular Haemorrhage Grade 3 and 4.

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  21. Number of participants Treated for Retinopathy (ROP)

    Rates of Retinopathy (ROP) receiving either retinal laser or intravitreal anti-VEGF therapy.

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  22. Number of days for each participant of Exposure to systemic analgesic or sedatives treatments

    Number of days with systemic analgesic or sedative treatments.

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  23. First cytokine dosage in tracheal aspirates.

    Mean Cytokines dosage from tracheal aspirates in intubated patients (one unique aspiration). This outcome will be assessed only for patients enrolled in the study and on mechanical ventilation between 24 and 48 hours of life.

    Measured: Between 24 hours to 48 hours of life.

  24. Second cytokine dosage in tracheal aspirates.

    Mean Cytokines dosage from tracheal aspirates in intubated patients (one unique aspiration). This outcomes will be assessed only for patients enrolled in the study and on mechanical ventilation between day 4 and 5 of life.

    Measured: Between day 4 to day 5 of life.

  25. Third cytokine dosage in tracheal aspirates.

    Mean Cytokines dosage from tracheal aspirates in intubated patients. This outcomes will be assessed only for patients enrolled in the study and on mechanical ventilation between day 10 and day 12 of life.

    Measured: Between day 10 to day 12 of life.

  26. Number of participants requiring hemodynamic support.

    Rates of patients receiving hemodynamic support during their hospital stay (systemic catecholamines, volume expansion).

    Measured: From enrollment in the study to the date of the end of the hospital stay, up to maximum 5 months of life

  27. Measurement of average weight gain for all study participants in each arm.

    Weight gain in grams between birth weight and weight at 36 weeks of corrected gestational age.

    Measured: From birth to the date of 36 weeks of corrected gestational age.

  28. Number of days for each participant in the study with central venous line

    Addition of all the periods the patients has a central line, in days.

    Measured: From birth to the date of the end of the hospital stay, up to maximum 5 months of life

  29. Resuts of Neurodevelopmental Follow-up for surviving participants.

    Results of the validated French version of the "Ages \& stages questionnaires" (ASQ3), a developmental screening tool based on parental reporting for their child. This tool will be sent to the parents, and collected.

    Measured: At 2 years of corrected age (± 2 months)

  30. Number of participants with Cerebral Palsy

    Rates of patients with cerebral palsy.

    Measured: At 2 years of corrected age (± 2 months)

  31. Number of participants with visual disorders at 2 years of age

    Rates of patients with severe visual disorders defined as a need for glasses at 2 years of corrected age (± 2 months)

    Measured: At 2 years of corrected age (± 2 months)

  32. Number of participants necessitating respiratory drugs during the two first years of life.

    Rates of patients with respiratory symptoms in the first two years, defined as the need for respiratory medications (inhaled or systemic) at any time in this period.

    Measured: From the date of discharge from the hospital to 2 years of age

Timeline

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

  1. First posted28 Mar 2024
  2. Study start13 Feb 2025 (estimated)
  3. Primary completion2 Apr 2027 (estimated)
  4. Study completion3 Apr 2029 (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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
144 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06334523
Sponsor's protocol ID
Volem
Acronym
Volem
Status last verified
Feb 2025
First submitted
18 Mar 2024
Last updated
5 Feb 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Ventilation with Dead Space Washout via Continuous Tracheal Gas Insufflation (CTGI) in people with Extremely Low Birthweight Infant and Continuous Tracheal Gas Insufflation, run by Centre Hospitalier Intercommunal Creteil at 4 sites in France.

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 5 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: opening soon, as of the sponsor's last update on 5 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in France. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Claude Danan, M.D. (+33609187562, claude.danan@chicreteil.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Cumulative duration of all periods of non-invasive ventilation (time frame: From birth to the end of hospital stay, up to maximum 45 weeks of corrected gestational age.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 5 Feb 2025.

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