Impact of CPAP Level on V/Q Mismatch in Premature Infants

Children's Hospital of Philadelphia (CHOP)

Status: Completed

Conditions: Infant, Premature, Diseases; Respiratory Insufficiency Syndrome of Newborn

Treatments: Device: Continuous positive airway pressure (CPAP); level changes

Study type: Interventional

Funder types: Other

Identifiers

NCT02983825

17-013910

825874 (Other Identifier)

Details and patient eligibility

About

Continuous positive airway pressure (CPAP) is used in premature infants to maintain lungs open and facilitate gas exchange. When ventilation/perfusion (V/Q) mismatch is present, areas of the lung that are open for gas exchange do not match up with the areas of the lung that are receiving blood for gas exchange. This study measure the responsiveness of V/Q mismatch to changes in the amount (or level) of CPAP.

Enrollment: 21 patients

Sex: All

Ages: 24 hours to 35 weeks old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Born at 27-35 weeks gestational age (GA) by best obstetric estimate, determined by the clinical obstetric team during antepartum admission.
2. Age limits: 24 hours of age - 35 weeks corrected gestational age.
3. On continuous CPAP support between 4-8 cm H2O for greater than 24 hours, as document on the bedside infant flow sheet.
4. Supplemental oxygen requirement, with a fraction of inspired oxygen (FiO2) 0.25 for at least 2 consecutive hours, as documented on the bedside infant flow sheet.

Exclusion criteria

1. Congenital anomalies, as determined by the clinical supervising physician.
2. Current or prior air leak syndrome, as determined by the clinical supervising physician.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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21 participants in 1 patient group

Continuous positive airway pressure (CPAP) level changes

Experimental group

Description:

Protocol guided changes in CPAP level from clinical baseline, with responsiveness in V/Q mismatch guiding subsequent changes; limited to a range of -2 to +3 cm H2O from baseline

Treatment:

Device: Continuous positive airway pressure (CPAP); level changes