Inhaled Nitric Oxide in Neonates With Elevated A-a DO2 Gradients Not Requiring Mechanical Ventilation
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Purpose
The purpose of this pilot study is to evaluate whether administration of nitric oxide (NO)gas by oxygen hood at 20 ppm significantly increases PaO2, as compared to placebo gas (oxygen), within one hour of initiation and with no significant adverse effects.
| Condition | Intervention | Phase |
|---|---|---|
|
Lung Disease Hypoxemia Respiratory Acidosis |
Drug: nitric oxide for inhalation Drug: Oxygen |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Treatment |
| Official Title: | Inhaled Nitric Oxide in Neonates With Elevated A-a DO2 Gradients Not Requiring Mechanical Ventilation |
- PaO2 level [ Time Frame: at baseline, then every hour for 6 hours ] [ Designated as safety issue: No ]
- Methemoglobin level [ Time Frame: at baseline then every hour of treatment ] [ Designated as safety issue: Yes ]
- Alveolar-arterial oxygen gradient and ratio [ Time Frame: after 1 hour of treatment ] [ Designated as safety issue: No ]
| Enrollment: | 7 |
| Study Start Date: | May 2002 |
| Study Completion Date: | June 2005 |
| Primary Completion Date: | June 2005 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Nitric Oxide for Inhalation
|
Drug: nitric oxide for inhalation
given at 20 ppm for 1 hour then weaned off over 4 hours
Other Name: INOmax
|
|
Placebo Comparator: 2
oxygen
|
Drug: Oxygen
given at 20 ppm for one hour, then weaned off over four hours
|
Detailed Description:
It is possible that administration of inhaled NO to neonates with abnormal gas exchange earlier, rather than later as a rescue therapy in a moribund state, might accelerate the transition of the circulation from the fetal to neonatal physiology and improve oxygenation. This may in turn decrease the need for mechanical ventilation, its associated morbidity and perhaps even ECMO.
This study is designed as a pilot study to evaluate the physiologic efficacy (rather than effect on clinical outcomes) of NO administered by hood in improving oxygenation of neonates with elevated A-a DO2.
Eligibility| Ages Eligible for Study: | up to 120 Hours |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion criteria:
- Gestational age >34 completed weeks (>=35)
- Age <48 hours
- A-a DO2 400 to 600, on two post-ductal arterial blood gases one hour apart, while on 100% O2 by oxygen hood
- Post-ductal arterial access
- Admitted to The University of Alabama Birmingham Regional NICU
Exclusion criteria:
- Cardiac disease (structural disease with right to left or mixing lesions), not including patent ductus arteriosus (PDA) or patent foramen ovale (PFO)
- Rapid deterioration requiring mechanical ventilation before entry into the study
- Major malformations
- Major neurologic or metabolic disorder or other illness leading to hypoventilation and hypercarbia
Contacts and Locations| United States, Alabama | |
| The University of Alabama Birmingham | |
| Birmingham, Alabama, United States, 35233 | |
| Principal Investigator: | Waldemar Carlo, MD | University of Alabama at Birmingham |
More Information
No publications provided by INO Therapeutics
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Robert Small, INO Therapeutics |
| ClinicalTrials.gov Identifier: | NCT00041548 History of Changes |
| Other Study ID Numbers: | CARLW1 |
| Study First Received: | July 10, 2002 |
| Last Updated: | June 9, 2010 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Acidosis Acidosis, Respiratory Lung Diseases Anoxia Acid-Base Imbalance Metabolic Diseases Respiratory Insufficiency Respiration Disorders Respiratory Tract Diseases Signs and Symptoms, Respiratory Signs and Symptoms Nitric Oxide Bronchodilator Agents Autonomic Agents |
Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Anti-Asthmatic Agents Respiratory System Agents Therapeutic Uses Free Radical Scavengers Antioxidants Molecular Mechanisms of Pharmacological Action Neurotransmitter Agents Endothelium-Dependent Relaxing Factors Vasodilator Agents Cardiovascular Agents Protective Agents |
ClinicalTrials.gov processed this record on May 23, 2013