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Respiratory Distress Syndrome, NewbornNCT06606444

Feasibility Study of Placement and Surfactant Administration Through a Preterm Size Laryngeal Mask Airway in Very Low Birth Weight Neonates With Respiratory Distress Syndrome

A study testing Surfactant Administration Through Laryngeal or Supraglottic Airways in people with Respiratory Distress Syndrome, Newborn, run by Karolinska Institutet at 1 site in Vietnam.

Completed

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

Official record
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Trial summary

Surfactant administration via a supraglottic airway device or laryngeal mask airway (SALSA) is a minimally invasive method of instilling surfactant in the trachea during spontaneous breathing and after applying nasal continuous positive airway pressure (nCPAP). Read more about this study

Who is it for?
Ages Up to 48 hours
Conditions the study is for
Respiratory Distress Syndrome, Newborn
What is being tested?
Surfactant Administration Through Laryngeal or Supraglottic Airways
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
1 siteVietnam
Study dates
20 Sep 2024to 1 Aug 2025
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 Up to 48 hours
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Parental informed consent, AND
  • Inborn neonate (=born in the hospital), AND
  • Gestational age less than 34 + 0 weeks, AND
  • Age less than 48 hours, AND
  • Birth weight from 750g to 1500g, AND
  • Clinical diagnosis of RDS requiring non-invasive respiratory support (CPAP/NIPPV) and fraction of inspired oxygen (FiO2) 0.30-0.60 to maintain oxygen saturation (SpO2) between 90% and 95%.

Who cannot join

  • Severe respiratory insufficiency in need of emergency intubation
  • Previous surfactant administration
  • Previous mechanical ventilation
  • Known pneumothorax
  • Major malformations
  • Investigators not available

Trial locations and contacts

1 site in 1 country.

Vietnam1 site
  • Phu San Hanoi Hospital - Hanoi Obstetrics and Gynecology Hospital

    Hanoi, 118000

Other trials in Vietnam

About this study

Official title: A Single-arm, Prospective Feasibility Study of Placement and Surfactant Administration Through a Preterm Size Laryngeal Mask Airway in Very Low Birth Weight Neonates, With Respiratory Distress Syndrome, at a Level III Neonatal Intensive Care Unit in Hanoi, Vietnam

Surfactant administration via a supraglottic airway device or laryngeal mask airway (SALSA) is a minimally invasive method of instilling surfactant in the trachea during spontaneous breathing and after applying nasal continuous positive airway pressure (nCPAP). However, the procedure has been limited from use in very low birth weight neonates, due to lack of preterm size LMAs, which are now emerging on the market.

The goal of this study is to see if investigators can successfully use a new, smaller laryngeal mask airway (LMA) to place and give surfactant to premature babies with respiratory distress syndrome (RDS) who weigh between 750g and 1500g at birth.

Read more

The main objectives of the study are to:

  • Check the placement of the new, smaller LMA: This includes evaluating the airway, how long it takes to place the LMA, how many attempts are needed, and the baby's stability during the process.
  • Evaluate the administration of surfactant using the new LMA: Investigators will look at how the baby responds clinically, any changes in oxygen needs, how many doses of surfactant are required, the level of respiratory support needed, and whether intubation or mechanical ventilation is necessary.
  • Ensure the safety of using the new LMA and administering surfactant: Investigators will monitor the baby's stability during the procedure and watch for any adverse events.
  • Assess pain during the procedure: Investigators will evaluate pain levels using a pain scale based on video reviews.

Above objectives of feasibility are to be assessed before proceeding to a large randomize clinical trial assessing effectiveness and safety.

Read the detailed description

Methodology Feasibility will be measure by a combination of real-life observations of the procedure and video-review with synced physiological data (oxygen saturation and heart rate).

Study Site The Phu San Hanoi Hospital, the largest obstetric hospital in northern Vietnam, receives about 40.000 births annually and has a level-III neonatal intensive care unit with capacity of approximately 40 neonates. Approximately 10-15 neonates weighing less than 1500g per month are admitted who receives standard surfactant treatment with IN-tubation-SURfactant-Extubation (INSURE).

Being tested
Surfactant Administration Through Laryngeal or Supraglottic Airways
Keywords
surfactant, laryngeal mask airway, supraglottic airway device, preterm infant, neonate, newborn, vietnam, feasibility, pilot, SALSA, RDS, respiratory distress syndrome, very low birth weight
Medical subject headings
Respiratory Distress Syndrome, Newborn, Premature Birth, Respiratory Distress Syndrome

What participants receive

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

  • Surfactant Administration Through Laryngeal or Supraglottic AirwaysDevice

    Also called Laryngeal mask airway surfactant administration, Surfactant Therapy via Laryngeal Mask Airway, Laryngeal Mask Airway for Surfactant Administration in Neonates, Supraglottic airway devices for surfactant treatment

    While the child is spontaneously breathing on nasal CPAP treatment, the neonatal intensive care (NICU) physician will place the LMA and assess for adequate airway by CO2-detection, chest movement, pulmonary auscultation of bilateral breath sounds, gastric insufflation, oxygen saturation and heart rate. A placement attempt should not last more than 30 seconds. Surfactant will be administered slowly in 1-2 ml aliquots (Curosurf 200 mg/kg) via an appropriate size laryngeal mask airway. The neonate should primarily be spontaneously breathing and if needed receives gentle supportive positive pressure ventilation (PPV). Gentle supportive PPV is given for 30 seconds after surfactant is administered, before LMA is removed.

Study groups in NCT06606444
Study groupRoleWhat they receive
Surfactant administered via laryngeal mask airwayExperimentalEnrolled infants will receive surfactant delivered via a neonatal size laryngeal mask airway.
Receives: Device: Surfactant Administration Through Laryngeal or Supraglottic Airways

What is being measured

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

  1. Successful LMA placement, with signs of adequate airway, allowing two attempts.

    Categorical variable (Yes/No)

    A successful placement attempt is defined as insertion of the LMA into the infant's mouth with signs of adequate airway, as per judgement of the physician performing the procedure. Factors that will be considered are carbon dioxide (CO2)-detection, chest movement, pulmonary auscultation of bilateral breath sounds, oxygen saturation and heart rate.

    Measured: During procedure. 0-30 minutes.

Secondary outcomes (35)
  1. Confirmation of carbon dioxide on carbon dioxide detector

    Categorical (Yes/No)

    Measured: During procedure. 0-30 minutes.

  2. Chest rise during LMA placement

    Categorical (Yes/No)

    Measured: During procedure 0-30 minutes.

  3. Bilateral breath sounds by auscultation during LMA placement

    Categorical (Yes/No)

    Measured: During procedure. 0-30 minutes.

  4. Number of attempts required for successful placement

    Numerical variable.

    Measured: During procedure. 0-30 minutes.

  5. Attempt duration more than 30 seconds

    Categorical variable (Yes/No)

    Measured: During procedure. 0-30 minutes.

  6. Duration of each LMA placement attempt

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  7. Time between attempts

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  8. Fluctuations in heart rate during placement

    Numerical variable (beats per minute). Difference between mean/median at baseline and during placement. Measured by pulse oximetry.

    Measured: During procedure. 0-30 minutes.

  9. Fluctuations in oxygen saturation (SpO2) during placement

    Numerical variable (percentage). Difference between mean/median at baseline and during placement. Measured by pulse oximetry.

    Measured: During procedure. 0-30 minutes.

  10. Fluctuations in heart rate during surfactant administration

    Numerical variable (beats per minute). Difference between mean/median at baseline and during surfactant administration. Measured by pulse oximetry.

    Measured: During procedure. 0-30 minutes.

  11. Fluctuations in oxygen saturation (SpO2) during surfactant administration

    Numerical variable (percentage). Difference between mean/median at baseline and during surfactant administration Measured by pulse oximetry.

    Measured: During procedure. 0-30 minutes.

  12. Duration of SpO2 less than 80%

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  13. Duration of SpO2 less than 60%

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  14. Duration of SpO2 less than 40%

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  15. Duration of heart rate less than 100 beats per minute (bpm)

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  16. Duration of heart rate less than 60 beats per minute (bpm)

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  17. Number of bradycardia less than 60 bpm for more than 10 seconds

    Numerical variable.

    Measured: During procedure. 0-30 minutes.

  18. Number of desaturations to less 80% for more than 30 seconds

    Numerical variable.

    Measured: During procedure. 0-30 minutes.

  19. Number of apneas lasting more than 20 seconds

    Numerical variable

    Measured: During procedure. 0-30 minutes.

  20. Volume of surfactant in gastric residuals after the procedure

    Numerical variable (milliliters)

    Measured: During procedure. 0-30 minutes.

  21. Total procedure duration

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  22. Duration of positive pressure ventilation during LMA placement

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  23. Duration of positive pressure ventilation during surfactant administration

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  24. Duration of positive pressure ventilation during procedure

    Numerical variable (seconds)

    Measured: During procedure. 0-30 minutes.

  25. Fraction of inspired oxygen

    Oxygen requirement to maintain SpO2 between 90-95%. Measured before start of procedure and at 5 minutes , 15 minutes , 30 minutes and 1 hour post-procedure.

    Measured: 10 minutes before procedure until 1 hour after procedure.

  26. Need for early redosing of surfactant

    Categorical (Yes/No)

    Measured: Within 6 hours from first surfactant administration

  27. Need for invasive mechanical ventilation within 72 hours

    Categorical (Yes/No)

    Measured: Within 72 hours after surfactant administration

  28. Death

    Categorical (Yes/No)

    Measured: Within 7 days after birth

  29. Duration of oxygen requirement after surfactant administration

    Numerical (hours)

    Measured: Within 7 days after birth

  30. Duration of continuous positive airway pressure (CPAP) after surfactant administration

    Numerical variable (hours)

    Measured: Within 7 days after birth

  31. Duration of non-invasive positive pressure ventilation (NIPPV) after surfactant administration

    Numerical variable (hours)

    Measured: Within 7 days after birth

  32. Duration of invasive mechanical ventilation after surfactant administration

    Numerical variable (hours)

    Measured: Within 7 days after birth

  33. Number of surfactant doses given

    Numerical variable

    Measured: Within 7 days after birth

  34. Need for subsequent intubation and mechanical ventilation

    Categorical variable (Yes/No)

    Measured: Within 7 days after birth

  35. Administration method for subsequent surfactant doses

    Categorical. (Surfactant via laryngeal mask airway OR Surfactant via Intubation-Surfactant-Extubation OR Surfactant via intubation followed by mechanical ventilation)

    Measured: Within 7 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 posted23 Sep 2024
  2. Study start20 Sep 2024
  3. Primary completion13 Jul 2025
  4. Study completion1 Aug 2025

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06606444
Sponsor's protocol ID
2090 CN/PS
Other IDs
2018-02770, 2018
Status last verified
Aug 2025
First submitted
9 Sep 2024
Last updated
19 Aug 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The datasets used and/or analysed during the current study will be available from the principal investigator on reasonable request after publication of results.

Publications

  • Abdel-Latif ME, Walker E, Osborn DA. Laryngeal mask airway surfactant administration for prevention of morbidity and mortality in preterm infants with or at risk of respiratory distress syndrome. Cochrane Database Syst Rev. 2024 Jan 25;1(1):CD008309. doi: 10.1002/14651858.CD008309.pub3.

    PubMed 38270182
  • Larsson M, Vu H, Nguyen LT, Nguyen HL, Nguyen HT, Tran NL, Nguyen H, Thi Pham PT, Nguyen TK, Elfvin A, Drevhammar T, Mai HT, Myrnerts Hook S, Alfven T, Pejovic NJ. Feasibility of Surfactant Delivery via Preterm Supraglottic Airways in Infants with Birth Weights of 800-1500 g. J Pediatr. 2026 Aug 4;299:115269. doi: 10.1016/j.jpeds.2026.115269. Online ahead of print.

    PubMed 42551730

Questions about this trial

What is this clinical trial studying?

A study testing Surfactant Administration Through Laryngeal or Supraglottic Airways in people with Respiratory Distress Syndrome, Newborn, run by Karolinska Institutet at 1 site in Vietnam.

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 6 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 19 Aug 2025. 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 Vietnam. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Successful LMA placement, with signs of adequate airway, allowing two attempts. (time frame: During procedure. 0-30 minutes.). 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 NCT06606444, which also lists 2 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 19 Aug 2025.

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