To determine the influence of different nCPAP levels on WOB and electrical activity of the diaphragm and to investigate if these parameters are correlated in preterm infants.
ID
Source
Brief title
Condition
- Neonatal respiratory disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Changes in work of breathing and electrical activity of the diaphragm at
different nCPAP levels.
Secondary outcome
The correlation of electrical activity of the diaphragm and work of breathing.
Background summary
Non-invasive respiratory support, in particular nasal continuous positive
airway pressure (nCPAP), is widely used in preterm infants to reduce work of
breathing (WOB), and thereby minimising the risk of respiratory muscle fatigue
and respiratory failure. However, the level of nCPAP support varies
considerable * between 0 and 8 cmH2O * during daily care because of pressure
loss via an open mouth and during nursing care at which time the infants are
taken off nCPAP. The effect of these fluctuations on WOB is unknown. WOB is
calculated out of data collected on changes in tidal volume and pleural
pressures during normal breathing. Pleural pressures in preterm infants are
measured with an oesophageal catheter. There is a need for more easy applicable
methods that provide continuous online information on WOB. The diaphragm is the
main respiratory muscle and end-organ of respiratory control in humans.
Measuring electrical activity of this muscle by transcutaneous electromyography
(dEMG) is feasible in preterm infants and might provide important information
on WOB. However, this possible correlation between WOB and dEMG in preterm
infants has so far not been investigated.
Study objective
To determine the influence of different nCPAP levels on WOB and electrical
activity of the diaphragm and to investigate if these parameters are correlated
in preterm infants.
Study design
Prospective observational study.
Study burden and risks
For this study, the feeding tube placed in the stomach for clinical use needs
to be repositioned in the oesophagus. This procedure will, at most, result in
minimal discomfort. The changes in nCPAP level only mimic daily changes over
time, therefore posing no extra burden to the patient. This study can only be
done in preterm infants because of the specific physiology of the immature
respiratory network and immature lung development in this specific population.
The study population will not benefit from participating in this research. This
study will expand our knowledge on respiratory support in preterm infants what
will benefit future care for these patients.
Meibergdreef 9
Amsterdam 1105AZ
NL
Meibergdreef 9
Amsterdam 1105AZ
NL
Listed location countries
Age
Inclusion criteria
- Born at less than 37 weeks GA
- Supported with nCPAP 4 to 6 cm H2O at time of inclusion
- Maximum FiO2 of 30%
- Stable clinical condition
- Written parental informed consent
Exclusion criteria
- Major congenital anomalies
- Clinical instability requiring frequent interventions by the nursing staff that may interfere with the measurement
- The attending physician considers the infant to be too vulnerable to participate in the study
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL54708.018.15 |