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Trial registered on ANZCTR
Registration number
ACTRN12610000452099
Ethics application status
Approved
Date submitted
27/05/2009
Date registered
3/06/2010
Date last updated
26/10/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
Assessment of lung derecruitment resulting from suction of the endotracheal tube in ventilated preterm infants
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Scientific title
The effect of endotracheal tube suction on lung derecruitment in ventilated preterm infants
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Secondary ID [1]
251930
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ventilated preterm infants
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Condition category
Condition code
Respiratory
237215
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The intervention consists of removal of the flow sensor followed by suctioning via a Bodai suction port using a 6-F catheter in infants on conventional ventilation. Each suction procedure will consist of approximately and will consist of 2 suction passes and conclude with re-insertion of the flow sensor back into the ventilatory circuit. Only one suction intervention will be measured and the entire procedure will take a maximum of 10 minutes.
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Intervention code [1]
236645
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Not applicable
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Comparator / control treatment
Uncontrolled
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Ventilation distribution using electrical impedance tomography (EIT).
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Assessment method [1]
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Timepoint [1]
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EIT measurements will be taken for 60 seconds before suction, and at 15, 30, 45, 60, 75, 90 105, 120 minutes post suction.
A 10 minute EIT measurement will be taken during suction.
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Secondary outcome [1]
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Physiological parameters such as heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), blood pressure (BP).
Ventilator parameters using the Draegar ventview program will be downloaded from the ventilator Oxygenation
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Assessment method [1]
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Timepoint [1]
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Ventilator parameters and physiological variables will be downloaded continuously from before suction and continue until 2 hours post suction.
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Eligibility
Key inclusion criteria
Gestation less than 32 weeks gestation (i.e. up to and including 31 weeks 6 days gestation)
Less than 7 days of age at onset of endotracheal ventilation
Birth weight of more than 750 grams
Duration of ventilation at enrolment of at least 12 hours
Expected to continue to receive mechanical ventilation before and after at least one episode of airway suction after enrolment
Satisfactory endotracheal tube position has been determined by chest radiograph
Arterial sampling line in situ (umbilical or extremity)
Parent(s) able and willing to provide informed consent
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Minimum age
No limit
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Maximum age
7
Days
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Air leak syndrome (e.g. pneumothorax, pneumomediastinum, pulmonary interstitial emphysema
Lung or cardiovascular anomaly that would substantially affect oxygenation, lung recruitment or regional ventilation, e.g;
o cyanotic or other major congenital heart disease (not including Patent Ductus Arteriosus)
o tracheo-oesphageal fistula
o space occupying thoracic lesion such as diaphragmatic hernia or eventration, or cystic adenomatoid malformation
Substantial leak around endotracheal tube (e.g.. >50%) precluding accurate non-invasive measurement of respiratory function
Significant hemodynamic instability (untreated shock, hypovolemia, hypotension)
Poor skin integrity precluding the use of adhesive electrocardiogram (ECG) electrodes.
Survival considered unlikely (death considered imminent or inevitable).
Both parents of baby under 18 years of age due to the complexities of obtaining consent.
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
10/11/2008
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Actual
10/11/2008
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Date of last participant enrolment
Anticipated
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Actual
9/09/2010
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
20
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Australia and New Zealand (ANZ) Trustees Childrens Medical Research Establishment Grant
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Address [1]
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GPO Box 389D
Melbourne
Victoria
3001
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Judy Hough
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Address
Physiotherapy Department
Mater Health Services
Raymond Terrace
South Brisbane
Queensland
4101
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
4544
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Mater Health Services
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Ethics committee address [1]
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Raymond Terrace South Brisbane QLD 4101
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
239124
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Approval date [1]
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14/08/2008
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Ethics approval number [1]
239124
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1209M
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Ethics committee name [2]
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Mater Health Human Research Ethics Committee
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Ethics committee address [2]
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Raymond Terrace South Brisbane QLD 4101
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Ethics committee country [2]
259127
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Date submitted for ethics approval [2]
259127
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Approval date [2]
259127
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Ethics approval number [2]
259127
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Summary
Brief summary
Infants on ventilatory support in neonatal intensive care regularly require suction to clear their airways of secretions. This process entails the introduction of a catheter into the endotracheal tube through which the infant is ventilated to suction the secretions. There are two brief episodes of disconnection from the ventilator (to remove then reinsert the flow measurement device, or pneumotachograph) before and after the suctioning. Although this is a necessary process, some infants experience a reduction in oxygenation possibly due to lung collapse from this procedure. In the past we did not have any good monitoring tool to assess the changes occurring in lung volume during and after suction in ventilated newborn infants. Electrical impedance tomography (EIT) is a new non-invasive lung volume monitoring tool, which is well suited to this purpose. Our study group has shown that EIT measures ventilation distribution highly accurately and gives information on the level of lung inflation in preterm infants. The purpose of the study is to attempt to examine the effect of endotracheal suction on ventilation distribution and lung de-recruitment in preterm infants.
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Trial website
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Trial related presentations / publications
Hough JL, Shearman AD, Liley H, Grant CA, Schibler A. (2014) Lung recruitment after endotracheal suction in ventilated preterm infants measured with EIT. Journal of Paediatrics and Child Health. 50 (11): 884 – 889. Published online June 2014. doi:10.1111/jpc.12661 Hough JL, Shearman AD, Liley HG, Grant CA, Schibler A (2011) Endotracheal suction procedure leads to transient lung derecruitment in ventilated preterm infants. Oral presentation at the Australian Physiotherapy Conference, Brisbane Hough J, Shearman A, Liley H, Grant C, Schibler A (2010) Lung derecruitment related to endotracheal suction in ventilated preterm infants. European Respiratory Society, Barcelona Poster 2705
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Public notes
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Contacts
Principal investigator
Name
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Dr Judith Hough
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Address
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Physiotherapy Department
Mater Health Services
Raymond Terrace
South Brisbane
QLD 4101
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Country
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Australia
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Phone
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61 422404369
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Judy Hough
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Address
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Paediatric Critical Care Research Group
Mater Health Services
Raymond Terrace
South Brisbane
Queensland
4101
Principal Investigator
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Country
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Australia
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Phone
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+61 422404369
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Fax
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+61 7 31631642
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Email
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[email protected]
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Contact person for scientific queries
Name
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Judy Hough
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Address
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Paediatric Critical Care Research Group
Mater Health Services
Raymond Terrace
South Brisbane
Queensland
4101
Principal Investigator
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Country
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Australia
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Phone
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+61 422404369
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Fax
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+61 7 31631642
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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