Bronchopulmonary Dysplasia, Patent Ductus Arteriosus, Preterm, Respiratory Distress Syndrome, Newborn
Conditions
Brief summary
In preterm infants with neonatal respiratory distress syndrome (RDS), exogenous pulmonary surfactant(PS) replacement therapy is one of the most important therapeutic breakthrough to reduce neonatal incidences of bronchopulmonary dysplasia(BPD) and/or death. But not all preterm infants with RDS can be beneficial. Otherwise, the international neonatal acute RDS (NARDS) collaborative group provides the first consensus definition for NARDS in 2017. And whether or not PS being beneficial in preterm infants with NARDS remains unknown.
Detailed description
To date, the optimal dose of PS is inconsistent, although the recommended dose of PS is given in the 2019 update guideline. PS is not recommended to adult and pediatric ARDS. Systematic review indicates that PS does not reduce the incidences of BPD and death in infants with meconium aspiration syndrome(MAS, a subtype of NARDS). A reasonable speculation is that preterm infants with NARDS do not benefit from PS. And the speculation can explain why not all preterm infants with RDS can be beneficial from PS. In the era of pre-NARDS, the preterm infants fulfilling the definition of NARDS may have been considered as RDS in the first three days after birth. Meantime, the dose of PS given to infants with NARDS remains unknown. the aim of the present study is to assess the optimal dose of PS. the control group: PS is given according to the European RDS management guideline in 2019 edition. The study group: PS is stopped when the pressure is equal between before patent ductus arteriosus(bPDA) and after PDA(aPDA). the primary outcomes are the closure rate of PDA within 7 days, the incidence of BPD and/or death.
Interventions
DRUGPS is stopped when the pressure is equal between bPDA and aPDA.
PS is given and stopped when the pressure is equal between bPDA and aPDA. the pressure is measured using ultrasound
DRUGPS is given according to the 2019 European RDS management guideline
PS is given according to the 2019 European RDS management guideline
Sponsors
Children's Hospital of Chongqing Medical University
Daping Hospital and the Research Institute of Surgery of the Third Military Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
1 Minutes to 12 Hours
Healthy volunteers
No
Inclusion criteria
* gestation age less than or equal to 32 weeks * PS is needed
Exclusion criteria
* main congenital abnormalities * parents' refusal or quit
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| BPD and/or death | at 36 week's gestational age | the BPD and/or death is diagnosed when the included infants remain needing oxygen at 36 week's gestational age |
| the size of PDA | within 7 days after birth | the size of PDA is zero |
Countries
China
Contacts
Primary ContactChen Long, PhD,MD
Outcome results
None listed