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High Frequency Ventilation in Premature Infants (HIFI)

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00000567
First Posted: October 28, 1999
Last Update Posted: April 14, 2016
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborator:
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Information provided by:
National Heart, Lung, and Blood Institute (NHLBI)
  Purpose
To compare the efficacy and safety of high frequency ventilation (HFV) with that of standard, mechanical ventilation in premature infants of less than 2000 grams.

Condition Intervention Phase
Bronchopulmonary Dysplasia Lung Diseases Respiratory Distress Syndrome Procedure: high-frequency ventilation Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Primary Purpose: Treatment

Resource links provided by NLM:


Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):

Study Start Date: August 1984
Detailed Description:

BACKGROUND:

In the early 1980s, there was increasing concern that the dramatic improvement in the survival of immature infants had been accompanied by an increase in incidence of pulmonary complications, some seriously crippling and eventually fatal. Both barotrauma and oxygen toxicity had been considered in the pathogenesis of these disorders; circulatory disorders as a result of failure of closure of the ductus arteriosus or fluid overload had also been proposed as contributory factors. Reports of successful application of the principles of high frequency ventilation (HFV) in the treatment of infants with RDS and particularly those with severe interstitial emphysema raised hopes that this technique might prevent barotrauma to the lungs and stimulated physicians and engineers to develop new equipment useful in ventilating small infants.

Although HFV had not been evaluated either with regard to efficacy or safety and although results of fundamental studies had not provided a good understanding of how gas exchange occurred during HFV, there was considerable interest in introducing this type of ventilatory support in neonatal intensive care. HFV involves the use of small tidal volumes, delivered at respiratory frequencies ranging from 1 to 40 Hz with the aid of, for example, a piston pump or a high speed jet of gas. Compared to conventional mechanical ventilation, HFV offers several potential advantages, including reduced intrapulmonary pressure swings and fluctuation in alveolar pressures and the possibility of lowered levels of inspired oxygen. At that time, theories suggested that HFV produced a pattern of flow that enhanced gas mixing and 'homogenized' the distribution of ventilation. Experimental observations in adult animals (cats, dogs and rabbits) or healthy newborn lambs had shown HFV to be effective in promoting gas exchange without apparent adverse effects. Studies in prematurely delivered subhuman primates, that develop RDS and subsequently bronchopulmonary dysplasia indistinguishable from that of human infants, supported the notion the HFV could provide better oxygenation and lower C02 levels than conventional mechanical ventilation at similar mean airway pressure. The HIFI trial provided badly needed controlled data on the safety and efficacy of HFV in premature infants.

Phase I, the Planning Phase, was initiated in August 1984. Recruitment and intervention began in February 1986 and ended in March 1987. Follow-up studies continued thru September 1988.

DESIGN NARRATIVE:

Subjects were randomized to either standard mechanical ventilation or high frequency ventilation. The principal endpoint was the incidence of bronchopulmonary dysplasia defined as: the need for supplemental oxygen on the 28th postnatal day and for more than 21 of the first 28 days after birth; and abnormal chest radiographic findings that persisted until the 28th day of age. Other endpoints included the need for ventilatory support, the incidence of crossover from one form of ventilatory support to the other, and mortality rate before the 28th day of postnatal age. Adverse effects considered were pulmonary air leaks, severe intracranial hemorrhage, and periventricular leukomalacia.

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   up to 1 Year   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria
Boy and girl infants weighing less than 2000 g. who required mechanical ventilation within 24 hours of birth and had been treated for less than 12 hours with conventional mechanical ventilation before randomization.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00000567


Sponsors and Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Investigators
OverallOfficial: Kenneth Poole RTI International
  More Information

Publications:
Study Data/Documents: Individual Participant Data Set  This link exits the ClinicalTrials.gov site
Identifier: HIFI
NHLBI provides controlled access to IPD through BioLINCC. Access requires registration, evidence of local IRB approval or certification of exemption from IRB review, and completion of a data use agreement.

ClinicalTrials.gov Identifier: NCT00000567     History of Changes
Other Study ID Numbers: 205
First Submitted: October 27, 1999
First Posted: October 28, 1999
Last Update Posted: April 14, 2016
Last Verified: December 2005

Additional relevant MeSH terms:
Lung Diseases
Respiratory Distress Syndrome, Newborn
Respiratory Distress Syndrome, Adult
Bronchopulmonary Dysplasia
Respiratory Tract Diseases
Respiration Disorders
Infant, Premature, Diseases
Infant, Newborn, Diseases
Ventilator-Induced Lung Injury
Lung Injury