COMPLETED

Pragmatic Research on Diuretic Management in Early BPD Pilot

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Babies who are born prematurely often develop a chronic lung disease called bronchopulmonary dysplasia (BPD). BPD puts babies at higher risk for problems with growth and development. Diuretics, such as furosemide, are frequently used in the management of early BPD). Many clinicians use informal trials of therapy to see if a baby responds to diuretics in the short-term before starting chronic diuretic therapy. Despite frequent use of diuretics, it is unclear how many babies truly respond to therapy and if there are long-term benefits of diuretic treatment. Designing research studies to figure this out has been challenging. The Pragmatic Research on Diuretic Management in Early BPD (PRIMED) study is a feasibility pilot study to help us get information to design a larger trial of diuretic management for BPD. Key questions this study will answer include: (1) Can we use an N-of-1 trial to determine whether a particular baby responds to furosemide? In an N-of-1 trial, a baby is switched between furosemide and placebo to compare that particular infant's response on and off diuretics. It is a more rigorous approach to the informal trials of therapy that are often conducted in clinical care. We hope to learn how many babies have a short-term response to furosemide ("responders"); (2) how many babies will still be on respiratory support at the end of the N-of-1 trial? This will help us determine how many patients would be eligible to randomize to chronic diuretic therapy in the second phase of the larger trail, and (3) if a baby is identified as a short-term responder, how many parents and physicians would be willing to randomize the baby to chronic diuretics (3 months) versus placebo in the longer trial?

Official Title

Pragmatic Research on Diuretic Management in Early Bronchopulmonary Dysplasia (PRIMED) Pilot Study

Quick Facts

Study Start:2023-08-17
Study Completion:2025-12-12
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:COMPLETED

Study ID

NCT05898022

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:2 Weeks to 10 Weeks
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD
Inclusion CriteriaExclusion Criteria
  1. 1. \<28 weeks gestation at birth
  2. 2. Post-Menstrual Age (PMA) of 29-32 weeks gestation
  3. 3. Requiring invasive positive pressure respiratory support or NIPPV/NIMV and FiO2 ≥ 25% or requiring non-invasive positive pressure respiratory support (NCPAP≥ 5 cm H20, BiPhasic CPAP) and FiO2 ≥ 30%.
  4. 4. Receiving enteral feedings of 120 mL/kg/day or greater
  5. 5. Expected to be hospitalized for at least 28 days after enrollment
  1. 1. Major congenital anomalies (e.g., known renal anomalies, congenital heart disease, congenital diaphragmatic hernia, or chromosomal anomalies)
  2. 2. In infants who had electrolyte testing in the week prior to enrollment, those with a serum creatinine \> 1.7 mg/dL, BUN \>50 mg/dL, Na \<125 mmoL/L, K ≤ 2.5 mmol/L, or Ca ≤ 6 mg/dL. Not having electrolyte testing in the week prior to enrollment is not an exclusion criterion.
  3. 3. Current treatment with Dexamethasone or hydrocortisone for respiratory failure. Treatment with chronic steroids for history of adrenal insufficiency or cardiovascular instability is not an exclusion criterion.
  4. 4. Treatment with any longer-acting diuretic (e.g., chlorothiazide, hydrochlorothiazide, acetazolamide) within 5 days of enrollment where exposure may result in carryover effects that confound the N-of-1 trial
  5. 5. Active order for standing, regularly scheduled diuretics (e.g., chronic diuretics)
  6. 6. Non-English speaking
  7. 7. Current treatment with ibuprofen or indocin

Contacts and Locations

Principal Investigator

Heather Kaplan, MD, MSCE
PRINCIPAL_INVESTIGATOR
Children's Hospital Medical Center, Cincinnati
Anna Maria Hibbs, MD, MSCE
PRINCIPAL_INVESTIGATOR
1. Rainbow Babies and Children's Hospital

Study Locations (Sites)

Emory University
Atlanta, Georgia, 30303
United States
RTI International
Durham, North Carolina, 27705
United States
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
United States
Case Western Reserve University, Rainbow Babies and Children's Hospital
Cleveland, Ohio, 44106
United States

Collaborators and Investigators

Sponsor: Children's Hospital Medical Center, Cincinnati

  • Heather Kaplan, MD, MSCE, PRINCIPAL_INVESTIGATOR, Children's Hospital Medical Center, Cincinnati
  • Anna Maria Hibbs, MD, MSCE, PRINCIPAL_INVESTIGATOR, 1. Rainbow Babies and Children's Hospital

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2023-08-17
Study Completion Date2025-12-12

Study Record Updates

Study Start Date2023-08-17
Study Completion Date2025-12-12

Terms related to this study

Keywords Provided by Researchers

  • furosemide
  • ventilator-induced lung injury
  • lung injury
  • lung diseases
  • respiratory tract diseases
  • infant
  • premature diseases
  • newborn
  • diseases
  • diuretics

Additional Relevant MeSH Terms

  • Bronchopulmonary Dysplasia