Non-invasive Ventilation in Preterm Infants

Summary

This is a prospective, observational cohort study. For the study part on noninvasive neurally adjusted ventilatory assist (NIV-NAVA) the design is interventional. For all participants prospective data collection will be conducted by chart review and by downloading ventilatory data from the ventilator. A registration of respiratory severity score will be done by a caregiver during the weaning period. This consists of a visual assessment of the work of breathing every 2 hours. For participants on NIV-NAVA consenting to the interventional part of the study a titration procedure will be conducted, afterwards serial electrical impedance tomography and lung and diaphragm ultrasound measurements will be done.

Conditions

• Premature Birth
• Respiratory Distress Syndrome
• Ventilator Lung; Newborn

Interventions

DIAGNOSTIC_TEST

Titration procedure

The NAVA level will be reduced to 0,5 cmH2O/microvolt (µV) for 3 minutes as a starting point. Limit peak pressure will be set to 35 cmH2O (the maxi-mum pressure that can be delivered to the patient is cut off at 30 cmH2O). Other ventilator settings will be left unchanged and are as clinically indicated. Starting from a NAVA level of 0,5 cmH20/µV the level will be increased by 0,5 cmH2O/µV every 3 minutes until reaching a maximum NAVA level of 2,5 cmH2O/µV.

DIAGNOSTIC_TEST

Electrical impedance tomography

This is a non-invasive technique consisting of the application of a non-adhesive single-use patient belt to monitor regional changes in lung aeration at the bedside.

DIAGNOSTIC_TEST

Lung and diaphragm ultrasound

Lung ultrasound is a non-invasive technique used to diagnose lung pathology and to monitor lung condition. This technique is part of the standard of care for preterm infants in our neonatal unit. Lung ultrasound scores are calculated at each time an ultrasound is performed. Ultrasound of the diaphragm consists of a short additional measurement of diaphragm thickness and thickening fraction and will be done at the same time of the lung ultrasound following a standardized procedure.

Sponsors & Collaborators

• Universitair Ziekenhuis Brussel

  lead OTHER

Principal Investigators

• Julie Lefevere, MD · Universitair Ziekenhuis Brussel

• Filip Cools, PhD · Universitair Ziekenhuis Brussel

• Brenda Van Delft, Nurse · Universitair Ziekenhuis Brussel

• Caitlin Jansen, Student · Vrije Universiteit Brussel

• Lissa De Potter, MD · Universitair Ziekenhuis Brussel

Study Design

Allocation

NA

Purpose

TREATMENT

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-02-01

Primary Completion

2025-06-03

Completion

2025-09-30

Countries

• Belgium

Study Locations