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DysphagiaPIOMINCT06395298

Effects of the Application of PIOMI in the Oral Feeding of Premature

A study testing Experimental group PIOMI in people with Dysphagia and Disorder; Feeding, Newborn, run by Fundació Sant Joan de Déu at 1 site in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is assess whether the application of the premature oral motor intervention (PIOMI) combined with the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), allows withdrawal of the external feeding device with guarantees of the patient's nutritional status… Read more about this study

Who is it for?
Ages 29 to 30 weeks
Conditions the study is for
Dysphagia, Disorder; Feeding, Newborn, Premature
What is being tested?
Experimental group PIOMI
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
35 participants
Where
1 siteSpain
Study dates
13 Feb 2023to 30 Dec 2026
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 29 to 30 weeks
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Neonates born at the Sant Joan de Déu Hospital with a gestational age between 29-30 weeks carrying an external feeding device due to the difficulty of oral feeding and that the medical team in charge considers clinically stable.

Who cannot join

  • Endotracheal intubation or high-flow ventilatory support.
  • Exclusive parenteral nutrition.
  • Hyporeactive due to the use of sedative drugs.
  • Condition of prematurity associated with other pathologies (syndromes, acquired brain damage, gastrointestinal malformations, airway and craniofacial malformations).

Trial locations and contacts

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

Raquel García Equerra contact

639423251

raquel.garciae@sjd.es

Vanesa Ejarque Marin contact

637797057

vanesa.ejarque@sjd.es

Spain1 site, 1 recruiting
  • Raquel García Ezquerra

    Barcelona, Catalonia, 08096

    Raquel García Ezquerra, raquel.garciae@sjd.es

    Vanesa Ejarque Marin, vanesaem35.vem@gmail.com

    Recruiting

Other trials in Spain

About this study

Official title: Effects of the Application of PIOMI (Premature Oral Motor Intervention) in the Oral Feeding of the Premature: Randomized Clinical Trial

The goal of this clinical trial is assess whether the application of the premature oral motor intervention (PIOMI) combined with the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), allows withdrawal of the external feeding device with guarantees of the patient's nutritional status, determining breastfeeding rates at hospital discharge and swallowing safety earlier than if only the care activity corresponding to the NIDCAP model is carried out, as well as the applicability of this standardised protocol in the neonatal intensive care unit of a tertiary hospital.

Read the detailed description

Prematurity is one of the most common factors affecting the development of oromotor skills, interfering with feeding. The most common clinical manifestation is uncoordinated sucking-breathing-swallowing cycle.

The incidence of oropharyngeal dysphagia in paediatrics is estimated at 10.40%, doubling in preterm infants weighing less than 1500 grams. The aetiological distribution of swallowing disorders in the neonatal age is highly variable, as is their clinical presentation. Current literature reflects the impact of the use of an external feeding device on the quality of life of the patient-family, as well as the increased health care costs due to prolonged hospitalisation, emergencies for device removal, consumables and enteral nutrition.

Current health models are based on prevention, hence the importance of establishing early protocols for assessment, diagnosis and intervention. The main difficulty in neonatal intensive care units is the loss of opportunity for oral feeding and the absence of standardised protocols, as there is great controversy regarding the intervention techniques that should be applied to promote the development of oral-motor skills.The PIOMI is the intervention model that currently presents the greatest scientific production, the results obtained in the studies carried out show a high success rate in relation to the initiation of oral feeding in preterm infants, as well as the maintenance of high breastfeeding rates at the time of hospital discharge and at 10 days, in compliance with the standards of the World Health Organisation (WHO).

At present, there are study designs of PIOMI, combined with olfactory-gustatory stimulation, but the latter is not specified as an oropharyngeal colostrum technique, which is currently indicated in the therapeutic guidelines, nor is the protocolised nursing care model described, an aspect that is of great importance because each hospital centre offers different care depending on whether or not the model is based on the individualised assessment and care programme for the development of the newborn.

This research aims to evaluate these aspects by means of a randomised double-blind parallel allocation clinical trial using Oxford Minimization and Randomization (OxMaR) software, to be carried out at the Hospital Sant Joan de Déu in Barcelona, in the neonatal intensive care unit in the period November 2023-2026. The sample size is n=35 preterm infants of gestational age 29-30+6.

The control group will follow the NIDCAP care model and the experimental group will apply the PIOMI+NIDCAP protocol for 5 minutes twice a day for 10 days, with olfactory stimulation and oropharyngeal colostrum for both groups.

The family will apply the intervention by accessing a quick response code with an information capsule according to the assigned group.

To identify factors, sociodemographic and health variables, process variables and outcome variables will be selected using the Neonatal Oral-motor Assessment Scale (NOMAS), Early Feeding Skills Assessment (EFSA) and pre- and post-tests will be analysed using variance analysis program (ANOVA) and statistical package for the social sciences (SPSS)

Being tested
Experimental group PIOMI, Control group NIDCAP
Keywords
Swallowing, Swallowing disorders, Nutritional support, Feeding disorders, Preterm, Neonates, Sucking Behavior
Medical subject headings
Deglutition Disorders, Premature Birth, Feeding and Eating Disorders, Sucking Behavior

What participants receive

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

  • Experimental group PIOMIOther

    Also called PIOMI+NIDCAP

    A group treated with the application of the care model Newborn Individualized Development Care and Assessment Program (NIDCAP) in the Neonatal Intensive Unit Care (NICU)+PIOMI

  • Control group NIDCAPOther

    Also called NIDCAP

    A group treated with the application of the care model Newborn Individualized Development Care and Assessment Program (NIDCAP) in the Neonatal Intensive Unit Care (NICU)

Study groups in NCT06395298
Study groupRoleWhat they receive
Experimental Group PIOMIExperimentalParticipants will receive: 1. The traditional intervention Newborn Individualized Development Care and Assessment Program (NIDCAP) model of the Neonatal Intensive Care Unit (NICU) .The nurse providing direct care to the patient and family, will carry out the relevant care of the patient. 2. The Premature Oral Motor Intervention (PIOMI) .The family will apply the PIOMI , 7 activities are intraoral stimulation for 10 consecutive days, twice a day, 5 minutes. 3. Gustatory stimulation technique:the application of oropharyngeal colostrum, a 0.5 milliliter twice a day 4. Olfactory stimulation Technique:A swab is moistened in breast milk and placed near the nose for one minute, twice a day.
Receives: Other: Experimental group PIOMI
Control Group NIDCAPSham comparatorParticipants will receive : 1.The traditional intervention Newborn Individualized Development Care and Assessment Program (NIDCAP) model of the Neonatal Intensive Care Unit (NICU).The nurse providing direct care to the patient and family, will carry out the relevant care of the patient. 3.Gustatory stimulation technique:the application of oropharyngeal colostrum, a 0.5 milliliter twice a day 4.Olfactory stimulation Technique:A swab is moistened in breast milk and placed near the nose for one minute, twice a day.
Receives: Other: Control group NIDCAP

What is being measured

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

  1. Time to remove the external feeding device

    To perform a proper calculation, the investigator must quantify the days of life in which the feeding device is placed and the date of effective removal

    Measured: Days of life of the baby when the external feeding device is removed assessed up to 30 days

Secondary outcomes (7)
  1. Volume of intake at discharge

    To perform a proper calculation, the investigator must quantify the volumen of milk in millilitres from the day of device removal until hospital discharge.

    Measured: Milliliters that the baby take orally until the day of hospital discharge up to 4 weeks

  2. Hospitalization days

    Quantify the days from birth to hospital discharge.

    Measured: Days that the premature baby remains hospitalized from birth to hospital discharge up to 12 weeks

  3. Breastfeeding patients after hospital discharge

    Quantify the babies who perform Breastfeeding, Deferred breastfeeding or Artificial Breastfeeding according to the group assigned at discharge.

    Measured: Number of patients who are breast-feeding after hospital discharge up to 12 weeks

  4. Deferred breastfeeding patients after hospital discharge

    Quantify the babies who perform Breastfeeding, Deferred breastfeeding or Artificial Breastfeeding according to the group assigned at discharge

    Measured: Number of patients who are Deferred breast-feeding after hospital discharge ,up to 12 weeks

  5. Formula feeding patients after hospital discharge

    Quantify the babies who perform Breastfeeding, Deferred breastfeeding or Artificial Breastfeeding according to the group assigned at discharge.

    Measured: Number of patients who are formula feeding after hospital discharge, up to 12 weeks

  6. Weight at hospital discharge

    To estimate the existence of significant differences between the group that presented intervention and the control.

    Measured: Assess weight discharge day, up to 12 weeks

  7. Weight ten days at hospital discharge

    Differences between discharge and 10-day weights

    Measured: Assess weight ten days at hospital discharge, up to 12 weeks

Timeline

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

  1. First posted2 May 2024
  2. Study start13 Feb 2023
  3. Primary completion3 Jun 2026 (estimated)
  4. Study completion30 Dec 2026 (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
Model description
* Assignment: Random and parallel using the OxMaR (Oxford Minimization and Randomization) software * Age range: 29-30 gestational weeks, both sexes will participate * Control group: Will receive the traditional intervention model of the Neonatal Intensive Care Unit (non-nutritive suction and kangaroo method) o Experimental group: Application of the PIOMI (Premature Infant Oral Motor Intervention) protocol, for 5 minutes twice a day, in a period of 10 days o Both groups will receive gustatory and olfactory stimulation * Intervention model: Parallel assignment * Description of the intervention model: Comparison of two groups, treated with the application of the care model in the NICU (Neonatal Intensive Care Unit) and the application of PIOMI (Premature Infant Oral Motor Intervention)
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
35 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06395298
Sponsor's protocol ID
C.I.PIC-108-22
Acronym
PIOMI
Status last verified
Apr 2024
First submitted
9 Jan 2023
Last updated
2 May 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Initially, the researchers plan to share the study protocol, the statistical analysis and the summary of results obtained, both in congresses and in publications, if applicable.

Publications

  • Grassi R, Farina R, Floriani I, Amodio F, Romano S. Assessment of fetal swallowing with gray-scale and color Doppler sonography. AJR Am J Roentgenol. 2005 Nov;185(5):1322-7. doi: 10.2214/AJR.04.1114.

    PubMed 16247157
  • Ghomi H, Yadegari F, Soleimani F, Knoll BL, Noroozi M, Mazouri A. The effects of premature infant oral motor intervention (PIOMI) on oral feeding of preterm infants: A randomized clinical trial. Int J Pediatr Otorhinolaryngol. 2019 May;120:202-209. doi: 10.1016/j.ijporl.2019.02.005. Epub 2019 Feb 5.

    PubMed 30851536
  • Lessen BS. Premature infant oral motor intervention (PIOMI) translating interventional research into interdisciplinary practice [Internet]. Unpublished; 2012. Disponible en: http://dx.doi.org/10.13140/RG.2.1.3652.696

  • Shailaja S J, Jayashri S K. Comparative study on the effect of oral motor intervention protocols on oral motor skills of preterm infants from tertiary care hospital in metropolitan city: pilot study. Int J ContempPediatr [Internet]. 2020;7(7):1506.

  • Tian X, Yi LJ, Zhang L, Zhou JG, Ma L, Ou YX, Shuai T, Zeng Z, Song GM. Oral Motor Intervention Improved the Oral Feeding in Preterm Infants: Evidence Based on a Meta-Analysis With Trial Sequential Analysis. Medicine (Baltimore). 2015 Aug;94(31):e1310. doi: 10.1097/MD.0000000000001310.

    PubMed 26252313
  • Pickler RH, Best A, Crosson D. The effect of feeding experience on clinical outcomes in preterm infants. J Perinatol. 2009 Feb;29(2):124-9. doi: 10.1038/jp.2008.140. Epub 2008 Oct 2.

    PubMed 18830247
  • Boiron M, Da Nobrega L, Roux S, Henrot A, Saliba E. Effects of oral stimulation and oral support on non-nutritive sucking and feeding performance in preterm infants. Dev Med Child Neurol. 2007 Jun;49(6):439-44. doi: 10.1111/j.1469-8749.2007.00439.x.

    PubMed 17518930
  • Lessen BS. Effect of Oral Stimulation on Feeding Progression in Preterm Infants. Adv Neonatal Care [Internet]. 2009 Aug [cited 2021 Feb 14];9(4):187. Available from: https://journals.lww.com/00149525-200908000-00021

Questions about this trial

What is this clinical trial studying?

A study testing Experimental group PIOMI in people with Dysphagia and Disorder; Feeding, Newborn, run by Fundació Sant Joan de Déu at 1 site in Spain.

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 1 inclusion and 4 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: looking for participants now, as of the sponsor's last update on 2 May 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 Spain. 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. Some participants in this study may receive a placebo. 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 Raquel García Equerra (639423251, raquel.garciae@sjd.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time to remove the external feeding device (time frame: Days of life of the baby when the external feeding device is removed assessed up to 30 days). 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 NCT06395298, which also lists 8 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 2 May 2024.

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