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Trial registered on ANZCTR
Registration number
ACTRN12624001314516
Ethics application status
Approved
Date submitted
1/09/2024
Date registered
29/10/2024
Date last updated
29/10/2024
Date data sharing statement initially provided
29/10/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Airway pressure measurements in newborns on non-invasive respiratory support: a feasibility study (AIRPREMO 2 Study)
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Scientific title
Pharyngeal pressure in newborns on non-invasive respiratory support: a feasibility study to assess a new airway pressure monitor (AIRPREMO 2 Feasibility Study)
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Secondary ID [1]
312863
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NIL
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Universal Trial Number (UTN)
U1111-1312-7838
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Trial acronym
AIRPREMO 2 Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Newborn Lung Disease
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Respiratory Distress Syndrome (RDS)
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Condition category
Condition code
Respiratory
331511
331511
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0
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Other respiratory disorders / diseases
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Reproductive Health and Childbirth
331512
331512
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0
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Complications of newborn
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In the AIRPREMO 2 Study, a modified TGA-approved dual-lumen gastric tube connected to a new external device will be used to measure the upper airway pressure (pharyngeal pressure) in newborns receiving non-invasive respiratory support (continuous positive airway pressure (CPAP) or high flow nasal cannula (HF)). Once inserted, the sensor lumen of the study feeding tube will be connected to a study sensor module unit which is connected to the study data acquisition unit (airway pressure monitor) that is positioned at the bedside. Pharyngeal pressure measurements will be obtained with the research data collection system for 3-8 days, with the data obtained from the study informing the development of a new device. Clinical staff will not have the ability to view the airway pressure data on the data acquisition unit unless shown by the research team.
The primary feeding lumen of the gastric tube will enable study participants to be fed as per usual clinical guidelines and facilitate enteral fluids/medication delivery as clinically required. The duration of recoding can vary from 3 to 8 days as outlined in our research protocol and as per clinical practices for replacement of tubes. Enteral feeds for infants on respiratory support are administered intermittently and advance (in volume and frequency) as the infant’s tolerance of feeding increases.
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Intervention code [1]
329401
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Other interventions
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Comparator / control treatment
This is a feasibility study to assess a new device with no control group. For participants on CPAP, the set CPAP pressures will be the comparator for the measured airway pressure and the comparisons will be processed over the duration of the recording period. For high-flow participants, the measured pressures (rolling average) will be related to the set high flow rate.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Pharyngeal pressure.
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Assessment method [1]
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Measure percent of time the device provides a pressure reading with visible breath waveform and a mean pressure of 0.5-12 cmH2O (as per pressure levels reached in previous study and in literature).
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Timepoint [1]
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At the end of recording period (3-8 days post commencement of the recording period).
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Primary outcome [2]
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Safety.
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Assessment method [2]
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Record incidence of complications/relevant clinical events that may be related to use of the device: Daily patient reviews will be conducted that report changes in care (medications, respirator support) and changes in clinical condition (such as abdominal distention, infection, feeding intolerance, aapnoeas, bradycardias, desturations etc). As part of this assessment the clinical team will be asked if any of the changes are felt to be study related.
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Timepoint [2]
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At the end of recording period (3-8 days post commencement of the recording period).
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Secondary outcome [1]
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Pharyngeal pressure for different HF/CPAP settings.
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Assessment method [1]
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Comparison of pharyngeal pressures delivered by different flow levels of HF with pharyngeal pressures delivered by CPAP set at different target pressures within and between participants.
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Timepoint [1]
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At the end of recording period (3-8 days post commencement of the recording period).
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Secondary outcome [2]
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Consistency of pharyngeal pressure at unchanged settings.
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Assessment method [2]
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Determine consistency of pharyngeal pressure delivered during periods of unchanged CPAP/HF over time delivered during periods of unchanged CPAP/HF over time.
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Timepoint [2]
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At the end of recording period (3-8 days post commencement of the recording period).
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Eligibility
Key inclusion criteria
Babies with a current weight of 1 kg or more treated at the Royal Women's Hospital Neonatal Intensive Care Unit receiving non-invasive respiratory support (CPAP or HF), requiring an orogastric or nasogastric feeding tube (for enteral feeding, gastric decompression and/or medication administration) and considered clinically appropriate for study enrolment as per the assessment of the treating neonatal consultant. Note: There will be a lead-in phase of the study, with the first 5 participants recruited weighing 1.5kg or more.
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Minimum age
0
Days
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Maximum age
1
Years
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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
Weight less than 1 kg.
Concurrent study that prohibits participation.
Anatomical anomaly of the nose, mouth, palate, neck, nasal or pharyngeal airway.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
As pharyngeal pressures are measured over a 3-8 day period, the mean pressures will be calculated from the raw pharyngeal pressure data after necessary data processing steps have been applied (calculated as a rolling average). For CPAP, which has a set pressure, the mean pressure will be compared to the set pressure. For high flow, the measured pressures will be correlated with the set flows. Pressure fluctuations will be correlated with a number of observed variables (eg. pressure/flow settings, type of patient interface, weight, age, participant behaviours, etc). The range of measured pressures will be determined. The data obtained from the study will be used for an assessment of the clinical utility of the device, enable further development of the device and guide the design of future research studies, rather than a formal statistical analysis.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/11/2024
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Actual
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Date of last participant enrolment
Anticipated
31/12/2025
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Actual
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Date of last data collection
Anticipated
14/01/2026
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Actual
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Sample size
Target
50
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
27054
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The Royal Women's Hospital - Parkville
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Recruitment postcode(s) [1]
43121
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3052 - Parkville
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Clinical Translation and Commercialisation Medtech Grant. MTPConnect (funded by the Medical Research Future Fund (MRFF) from the Australian Government Department of Health and Aged Care)
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Address [1]
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Country [1]
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Australia
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Funding source category [2]
317307
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Commercial sector/Industry
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Name [2]
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Ventora Medical Pty Ltd
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Address [2]
317307
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Country [2]
317307
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Women's Hospital Melbourne
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Address
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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]
319587
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Address [1]
319587
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Country [1]
319587
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Royal Women's Hospital Human Research Ethics Committee
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Ethics committee address [1]
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https://www.thewomens.org.au/research/research-resources-and-ethics
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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06/03/2024
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Approval date [1]
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24/04/2024
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Ethics approval number [1]
316036
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ERM 106742 RWH 24/10
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Summary
Brief summary
While continuous positive airway pressure (CPAP) and high flow nasal cannula (HFNC) are commonly used for treatment of infants with respiratory distress, the optimal level of CPAP/HFNC remains somewhat uncertain. Due to leaks occurring at the nostrils, the mouth and into the stomach, not all of the pressure generated by CPAP/HFNC is transmitted to the airway. Continuous measurement of the patient’s pharyngeal pressure could provide clinicians with important information. The proposed research is a feasibility study to measure the pharyngeal pressure in a convenience sample of up to 50 infants receiving CPAP/HFNC for the purpose of confirming the performance and safety of a new airway monitoring device. TGA-approved dual lumen gastric tubes will be modified to allow for airway pressure measurements in the pharyngeal region using a new airway pressure device (under development). The modified gastric tube will be used similar to regular gastric tubes, and pharyngeal pressures recorded over a 3-8 day period. The modified gastric tube will enable study participants to be fed as per usual clinical guidelines and facilitate enteral fluids/medication delivery as clinically required.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Christiane Theda
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Address
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Royal Women's Hospital, Neonatal Services, 20 Flemington Road, Parkville VIC 3052.
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Country
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Australia
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Phone
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+61 03 8345 2671
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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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Christiane Theda
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Address
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Royal Women's Hospital, Neonatal Services, 20 Flemington Road, Parkville VIC 3052.
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Country
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Australia
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Phone
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+61 03 8345 2671
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Fax
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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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Christiane Theda
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Address
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Royal Women's Hospital, Neonatal Services, 20 Flemington Road, Parkville VIC 3052.
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Country
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Australia
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Phone
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+61 03 8345 2671
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Only summarised data will be available for sharing/publication.
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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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