A Pilot Study of Continuous Negative Pressure (CNEP) In Bronchiolitis

ISRCTN ISRCTN53796751
DOI https://doi.org/10.1186/ISRCTN53796751
Secondary identifying numbers N/A
Submission date
05/03/2004
Registration date
05/03/2004
Last edited
09/08/2021
Recruitment status
Stopped
Overall study status
Stopped
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Martin Samuels
Scientific

Academic Department of Paediatrics, University Hospital of North Staffordshire
Stoke on Trent
ST4 6QG
United Kingdom

Phone +44 (0)1782 552832
Email samuels@doctors.org.uk

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeNot Specified
Scientific titleA Pilot Study of Continuous Negative Pressure (CNEP) In Bronchiolitis
Study objectivesNot provided at time of registration
Ethics approval(s)Not provided at time of registration
Health condition(s) or problem(s) studiedBronchiolitis
InterventionInfants were randomised to either standard treatment, or standard with CNEP.
Inspired oxygen requirement was measured with a calibrated oxygen analyser placed close to the infant's nose in a headbox, in which the oxygen flow was adjusted to maintain SaO2 96-99% at rest, measured with a Nellcor N-200 pulse oximeter.
When an infant fulfilled the entry criteria, written informed consent was obtained from parents and baseline data was collected.
Patients were then randomised to either conventional therapy or conventional therapy plus CNEP. The randomisation was performed using a stratification scheme to achieve a measure of balance in the treatment groups.
Conventional therapy in these hospitals included the use of additional inspired oxygen and bronchodilators. Infants were intubated and positive pressure ventilation (PPV) was initiated in the presence of respiratory acidosis with a pH below 7.25, hypercapnia, hypoxaemia in spite of additional inspired oxygen, recurrent apnoea and respiratory fatigue.
CNEP was applied using purpose built systems (Horner and Wells Ltd, Chelmsford, UK, and DHB Tools Ltd, Leamington Spa, UK).
Treatment was begun with -4 cmH2O of CNEP. If the FiO2 required to achieve normal SaO2 did not decrease within the next 30 min, CNEP was decreased to -6 cmH2O. Weaning from CNEP was attempted after a treatment period of at least 24 hours and usually in the presence of an FiO2<0.3.
Infants were fed by either nasogastric tube, or intravenously, according to the degree of respiratory distress.
Heart rate, respiratory rate and FiO2 were recorded hourly if the infants were at rest when they were treated with additional inspired oxygen.
Intervention typeOther
Primary outcome measureNot provided at time of registration
Secondary outcome measuresNot provided at time of registration
Overall study start date01/01/2004
Completion date31/12/2004
Reason abandoned (if study stopped)Objectives no longer viable

Eligibility

Participant type(s)Patient
Age groupNeonate
SexNot Specified
Target number of participants42
Key inclusion criteriaForty two infants admitted with bronchiolitis, who needed more than 40% oxygen therapy to maintain normal levels of arterial oxygen saturation. This was a pilot study. Forty two patients were enrolled between January 1991 and April 1992 in two paediatric hospitals in England (North Staffordshire Hospital and Royal Berkshire Hospital) if they fulfilled the following criteria:
1. Clinical diagnosis of bronchiolitis (irrespective of whether respiratory syncitial virus was isolated)
2. Age 1 year
3. Presence of respiratory failure with fractional inspired oxygen (FiO2) 0.4 to achieve an arterial oxygen saturation (SaO2) of 96-99%.
Key exclusion criteriaInfants with bronchopulmonary dysplasia (BPD), congenital cardiac, pulmonary or neuromuscular diseases or signs of upper airway obstruction were excluded.
Date of first enrolment01/01/2004
Date of final enrolment31/12/2004

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Academic Department of Paediatrics, University Hospital of North Staffordshire
Stoke on Trent
ST4 6QG
United Kingdom

Sponsor information

University Hospital of North Staffordshire (UK)
Government

Newcastle Road
Stoke on Trent
ST4 6QG
United Kingdom

Phone +44 (0)1782 552832
Email info@uhns.nhs.uk
Website http://www.uhns.nhs.uk

Funders

Funder type

Government

North Staffordshire and Royal Berkshire Hospitals

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Editorial Notes

09/08/2021: Internal review.
14/09/2017: The trial was completed early due to problems with equipoise in 1992. The results were published as an abstract only.