RecruitingNot ApplicableNCT06550219

Evaluation of Nasal Non Invasive Ventilation in Management of Neonates With Respiratory Distress Using Lung Ultrasound

Evaluation of Nasal Non Invasive Ventilation Modalities in Management of Neonates With Respiratory Distress Using Lung Ultrasound


Sponsor

Alexandria University

Enrollment

30 participants

Start Date

Nov 20, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

This study aims to evaluate the effect of non-invasive ventilation (nIPPV) , (nCPAP), and nasal high flow cannula (NHFC) as a primary mode of ventilation in preterm neonates \<37 gestational week with moderate to severe RD using LUS as regard: I. Primary outcomes: Duration of non-Invasive ventilation. II. Secondary outcomes: Evaluation LUS over the 1 st 7 days of life or weaning from ventilation. Need for intubation and invasive ventilation. Duration of respiratory support. Need for surfactant. Oxygen saturation index and oxygen index. Broncho-pulmonary dysplasia; grade. Duration of hospital stay


Eligibility

Min Age: 1 HourMax Age: 24 Hours

Exclusion Criteria8

  • Obvious major congenital abnormalities.
  • Any of the baby intubated for resuscitation or for other reasons.
  • Neonates need invasive mechanical ventilation.
  • Pulmonary hemorrhage.
  • Severe cardiovascular instability.
  • Cardiopulmonary arrest needing prolonged resuscitation.
  • Birth asphyxia (one-minute Apgar score ≤ 3).
  • Major cardiac diseases (not including patent ductus arteriosus).

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Interventions

DEVICENasal humidified heated high flow cannula (NHHHC)

Patients in this arm will receive humidified heated high flow using Vapotherm device, USA. Stating with 2 L/min flow and increase gradually till 8L/minute, guided by oxygen requirements.

DEVICENasal intermittent positive pressure ventilation (NIPPV)

Patients in this arm will receive both PEEP (positive end expiratory pressure ) and PIP (peak inspiratory pressure) using SLE 5000/6000 device, UK . Pressures will be adjusted according to severity of respiratory distress.

DEVICENasal continuous positive airway pressure NCPAP

Patients in this arm will receive PEEP (positive end expiratory pressure ), stating from 5 mbar to reach maximally 8 mbar.

DEVICElung ultrasound

Lung ultrasound (LUS) machine is a mobile device (Philips HDll XE, USA) with s8-3 probe with a frequency range of 8-3 MHz will be used as ultrasound machine. Throughout the period of non-invasive respiratory support Patient will be monitored by: LUS,Heart rate, Respiratory rate, Mean arterial pressure, Oxygen saturation index, Oxygen index, PaO2, blood gases and Fractional inspired oxygen (Fio2).


Locations(1)

Alexandria university, Elshattbi hospital

Alexandria, Egypt

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NCT06550219


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